26742 with 26776
26742 alone
26608 alone (I don’t like this either but this was suggested by another coder)
or something completely different?
Opinions please
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Question: In researching CPT® code 49905 Omental flap, intra-abdominal (List separately in addition to code for primary procedure), I found an article in AAPC’s Knowledge Center, dated 10/01/2013, titled “Omental Pedical Flaps,” that states this is an open surgical code. Does this mean I cannot this add-on code for laparoscopic procedures? Answer: Code 49905 describes the use […]
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I need some clarification please on the following scenario:
Patient was seen in the ED Dept for consult on 3/27/19 by Ortho diagnosed with Right Radial Head Fracture, she will be taken to OR 04/08/19. Dr. wants to charge for closed treatment w/consult??? Is this possible???:confused:
TIA,
Can anyone help me code for a closed reduction and percutaneous pinning of intra-articular proximal phalanx fracture of the thumb? The two codes I am looking at are 26727 and 26742. I can’t decide which one is right because 26727 specifies proximal phalanx, while 26742 specifies articular. Any suggestions?
Thanks!:)
Since the wound edges are not approximated and wound not completely closed, I would not bill the 12001. Am I correct in that statement and is there another procedure code this would fit that I’m not finding?
Pt. is seen in E.R. by Ortho physician & physician documents that ankle fx is too swollen to go to the O.R. Pt. will be scheduled at a later date after swelling subsides. The physician is wanting to bill for an E.R. visit and closed treatment of the ankle fx even though he documents that the pt. will be going to surgery after the swelling subsides. To me, this is "double dipping". So I’m looking for written documention for this scenario please. Any help/guidance/info would be muchly appreciated! TIA
My orthopedic surgeon wants to bill for a closed reduction w/o manipulation code (24500) on 6/8 and bill for the ORIF (24515) on 6/9 (the following day). I advised the provider that all he did on 6/8 was assessed the condition and plan for surgery therefore, 24500 is not separately billable. According to the guideline I’m currently reviewing "if plan is for manipulative procedure at a future date, non-manipulative fracture management should not be billed" If however, "treatment is instituted, with the possibility for a manipulative procedure at a future date, bill non-manipulative fracture management". In this case, the provider already knew and planned for surgery the next day.
My understanding is that closed reduction codes without manipulation involve treating a fracture until is healed that’s why they carry a 90-day global day.
My provider wants me to add modifier 58 to the ORIF code but I think is inappropriate. I honestly think all he should be billing for 6/8 is the E/M code along with modifier 57 and for 6/9 bill for the ORIF.
Any opinions will be appreciated.
Thank you.
Is it commonplace to bill 20690 (uniplanar external fixator) and 27825 (closed manip tx pilon) at the initial surgery, and at the time of the definitive surgery, to bill 27827 (open tx pilon) with a 58 modifier.
The physicians thought is that the closed manipulation is a separate procedure from the external fixator, done as a separate and specific maneuver during surgery, and is a necessary step in temporizing an injury. Therefore, the closed manipulation should be coded separately, and is not inherently bundled into the external fixator code. I just need clarification and a reference, if possible.
This is not a case where fixator is applied and closed treatment did not repair the fracture, and the decision was made to return to the OR for open treatment which would be billed with a -78 modifier.
Questions I have are:
1) Is the physician meeting the global requirements of the closed procedure (number of visits required, etc.)
2) Is it acceptable to bill a patient for 2 related procedures at full reimbursement for the same fracture?
I am trying to confirm if our surgeon can submit both cpt codes 27810 and 27814 done on the same day but different encounters. Pt was seen in ER and closed reduction was performed under conscious sedation. It was discussed with the pt and family since there still was displacement of the medial mallous fragment ORIF would be performed, pt went directly to OR from ER. Please advise and thank you in advance!