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Closed Reduction with manipulation and percutaneous K-wire fixation

Patient had a closed reduction with manipulation and percutaneous K-wire fixation of left ring finger proximal phalanx intraarticular head fracture. Provider is saying to use CPT 26548 which I totally disagree with but am going back and forth with how to code this one.
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

Medical Billing and Coding Forum

billing for manipulation and surgery

Good morning

"I saw him at GSH ER and performed a closed reduction under sedation by the anesthesia service. Residual displacement was noted. I recommended office follow-up to discuss surgical intervention. He complains of some ongoing discomfort in the splint.

Patient subsequently has surgery.

Question: Does the initial manipulation get billed?

Medical Billing and Coding Forum

Metacarpal fractures without manipulation

Our patient had 2 (4th & 5th) metacarpal fractures on the same hand. We treated the patient non-operative with a cast without manipulation. Our provider would like to charge CPT code 26600 x 2. We are thinking since the fractures are on the same hand and being treated with one cast, we should only charge one unit for the fracture code. Any thoughts or advice would be greatly appreciated.

Medical Billing and Coding Forum

Closed Reduction W/o Manipulation Code Billed the Day Prior to ORIF

Good afternoon,

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.

Medical Billing and Coding Forum

Cystoscopy with forceps manipulation of ureteral stent

Is there a code for the manipulation of a ureteral stent?

Procedure : Cystoscopy, forceps manipulation of left ureteral stent, replacement of indwelling Foley catheter
*
Details of Procedure: The patient was taken to the OR. Time-out completed. Sterilely prepped and draped in dorsal lithotomy position, and administered monitored anesthesia 30 degree cystoscope lens was passed with 22 French sheath into the bladder. Normal anterior urethra. Benign prostatic hyperplasia with obstruction and high bladder neck. The stent was visualized emanating from left ureteral orifice, and this was visualized fluoroscopically at the proximal end of the stent as well. With direct and fluoroscopic visualization, the stent was grasped initially with 30 and subsequently 70 degree lens and grasping forceps, and the stent was manipulated out distally to bring the curl of the stent back in the expected position of the left renal collecting system. Position appeared much improved. There was significant redundancy in the bladder once I then pushed the stent back using sheath of the cystoscope into the bladder, but we were very pleased with the overall position. The scope was withdrawn.
*
Fourteen French Foley catheter well lubricated was passed with sterile technique in the bladder, with return of clear irrigating fluid. 10 milliliter sterile water used to inflate balloon.

Thanks

Medical Billing and Coding Forum

CPT 23700: Shoulder Manipulation With Anesthesia

When reporting CPT® 23700 Manipulation under anesthesia, shoulder joint, including application of fixation apparatus (dislocation excluded) general anesthesia—not local, moderate sedation, etc., is required. Per CPT Assistant (April 2005): CPT code 23700 is intended to be reported for the manipulation only when performed under general anesthesia. The code descriptors, which include the phrase “requiring anesthesia” […]
AAPC Knowledge Center