Laureen shows you her proprietary “Bubbling and Highlighting Technique”
Download your Free copy of my "Medical Coding From Home Ebook" at the top right corner of this page
Medicare Advantage Organization denials raise concerns that private insurers are maximizing profits at the expense of patients. Every year, tens of thousands of people enrolled in private Medicare Advantage (MA) plans are denied necessary care that should be covered under the program, federal investigators concluded in a report published on April 27. The Department of […]
The post MA Plans Wrongly Deny Needed Care, Physician Payments appeared first on AAPC Knowledge Center.
As always, there are many more examinees at this time of the year than there are locations to accommodate them. We strongly encourage you to increase the number of seats at your existing exams, or even schedule an additional exam in December, if possible. We would be happy to open the scheduling tool if the […]
The post Extra Exam Sites and Seats Are Needed appeared first on AAPC Knowledge Center.
However, on several lists they include the abbreviation O/E, and I just can’t figure it out.
Does anyone here know what it means??
Thanks!!
Annette
I’m certainly leaning one way but would like to hear what others
say / see if there’s anything definitive out there about this.
Thanks.
Here is what I coded so far:
28750-LT Dx- M20.22, M96.0, M05.9 Arthrodesis,*great toe;*metatarsophalangeal*joint
20680-LT Dx- T84.84XA, T84.213A Removal of implant; deep (eg, buried wire, pin, screw, metal band, nail, rod or plate)
38232 Dx- M20.22, M96.0, M05.9, T84.84XA, T84.213A Bone marrow*harvesting for*transplantation;*autologous 1
Operation findings when his follow; patient was brought into the operating room and after
sedation intubation on the gurney the patient then was placed on operating table in normal
supine position. left thigh tourniquet was placed which was well-padded the left lower extremity
then was prepped and draped in normal sterile fashion.
Attention was made to the anterior medial proximal tibia where a 1 em incision was made this
incision was deepened with blunt dissection down to the anterior medial cortex of the proximal
tibia before we entered the lightning bone marrow aspiration needle under power intramedullary.
We aspirated 60 cc of bone marrow aspirate concentrate this was handed off to the back table
where it would be center fused to 5 cc concentration. This wound then was irrigated closed with
a 4-0 nylon Xeroform 2 x 2 and a Tegaderm
left lower extremity then was exsanguinated and elevated tourniquet was inflated to 275 mmHg
pressure. Attention was made to the dorsal medial aspect of left first metatarsal phalangeal joint
where there is noted to be prior surgery this old incision was used as our new incision just medial
to the extensor hallucis longus tendon. This incision was straight down to bone with significant
amount of scar tissue all soft tissue reflected off of the first metatarsal head and the base of the
proximal phalanx. There was noted to be a proud screw backing out in the plantar medial aspect
of the first metatarsal head 3 oh headless compression screw that was tenting the skin all soft
tissues were released off of this and this was pulled out in toto will be sent to pathology. There
was a dorsal plate 4 hole that was broken right at the joint 2 screws proximal to screws distally
these were removed along with the broken plate and will be sent the pathology. There was no
signs of any infection or corrosion of any of the implants. There is noted to be nonunion fibrous
of the first MPJ. This time the joint then was prepared for revision arthrodesis by removing any
scar tissue fibrosis within the joint subchondral drilling of the subchondral plate of the first
metatarsal head and the base the proximal phalanx wound was copiously irrigated we then took a
5 mm first metatarsal head wedge allogenic graft from Paragon soaked in bone marrow for over
3 minutes and then put that in our joint for a distraction arthrodesis with good anatomical fit At
this time the first MPJ was placed in a proximally 5 degrees of dorsiflexion and about 5 degrees of
abduction we held this with 2 crossing wires we then using good AO techniques placed a large
first metatarsal phalangeal joint plate from Paragon using 6 3.5 fully threaded screws that were
locking we reviewed this multiple times intraoperatively under fluoroscopy using AP and lateral
making sure R’s platelet was well adhered to the bone with good alignment in all of our screws
were a good length. Once our plate and screws were satisfactory along with our alignment we
removed all temporary wires we then made the bone graft with demineralized bone matrix
approximately 2 cc and bone marrow aspiration 3 cc mixed with 1 cc of amnion right at our
arthrodesis site. Following this we then closed the wound using 3-0 Vicryl for the deep capsule
was then injected the other 2 cc of bone marrow aspiration concentrate and underneath the
capsule and then closed the skin with a 3-0 nylon postoperative injections included 10 cc of half
percent Marcaine plain. This is followed by overnight ointment Adaptic 4 x 4 fluffs Kerlix and an
Ace bandage. Tourniquet was dropped there is good perfusion all digits hemostasis was
controlled.
I’m hoping someone may have the same situation or can provide some guidance/opinion on the change from the 96111 which was deleted and replaced this year with the 96112-96113. In our pediatric practice we have a staff member who has a Master of Arts in Educational Psychology who is trained and oversight provided by our Developmental physicians. The problem I am running into is that the addition of "physician or other qualified health care professional" this year to the new codes would basically now exclude us from using her to administering these tests. Our workflow in that clinic is that the patient/parent come in and see this staff member who administers/scores the testing and then they go directly to the physician afterwards and spend additional time with them in observation and discussion. The testing 96111 as well as an office visit charge was all billed under the MD. Now we are basically being told because of this change in verbiage that we would need to get rid of this staff person and put it all on the physician.
I’m curious as to how other clinics have handled this or if you have used other staff to perform the developmental testing.
Thank you
T