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New to ortho coding

Hi, I am hoping someone can help us, as we just had an orthopaedic practice join our group.

Our provider applied a dorsal aluminum splint for his patient, for tenosynovitis of the left small finger. He submitted the code A4570, which was denied by the insurance carrier. Another coder suggested trying S8450 or Q4049 instead. Can anyone tell me which code you would use for this service, and what the difference is between the three codes?

Thank you!

Medical Billing and Coding Forum

Ortho Glass

Does anyone use/bill for Orthoglass? We have a couple questions and hope someone can advise us.

Ortho bills for casting/splint materials and they use something called Ortho Glass which is fiberglass with padding around it. Would A4590 be the correct CPT for billing this material?

How much Ortho Glass in yards would this cpt cover? There was question over how many cpt units to bill for if they use X amount of yards on a patient.

thanks

Medical Billing and Coding Forum

Ortho docs making rounds for other docs patients

The practice I bill for is a private practice but some of the providers do rounds at our affiliated hospital. Many times they are checking on patients that are admitted under or have had surgery with the providers from other groups. Can I bill for my doc’s visits that they do during rounds and checking on other patients? We have our own Tax ID that we bill under.

Thank you in advance.
Katie CPC, CPMA

Medical Billing and Coding Forum

Can you bill e/m with fracture care for first visit to Ortho?

Patient was seen in ER and splint was applied. Next day the patient came to the Ortho office as a new patient where a new splint was applied, xrays reviewed, care instructions given and follow up apt made. Doctor billed 26600 fracture care code, can we bill for an e/m with 57 as well since patient was new and decision for fracture care was made at that time? And if there’s any credible sources/articles I can reference? Thank you in advance!

Medical Billing and Coding Forum

Ortho Coding training

I have my CPC, and have just begun working in Ortho. I am looking for a good web based learning option that can help me get some knowledge until I do a full three day seminar in Feb. All I can find is the 2019 coding updates. Does anyone know where to find a general ortho learning experience via the web? Please e mail me any options to [email protected]
Thanks
Missy

Medical Billing and Coding Forum

Transfer care with in same Ortho practice

I have a patient was in an accident and was seen in the hospital by a doctor in our group. The doctor did not operate on the patient, only consulted on the patient’s fractures. The fractures are going to be treated conservatively so the doctor charged the 3 corresponding fracture codes without manipulation. The patient has had 2 post op/follow up appointments with this doctor. Now the patient doesn’t like this doctor and wanted a 2nd opinion from another doctor in the same group, same tax ID #. Is there anything that can be charged like an office visit for a 2nd opinion for the 2nd doctor? I don’t feel like we can do a corrected claim on the first doctor’s fracture charges as the patient did follow up twice with him. Any advice would be much a appreciated. Thanks.

Medical Billing and Coding Forum

Ortho help

One of our physicians did an Right Periacetabular Osteotomy with application of external fixator. One week later, post op x-ray indicates loss of reduction, so he performed what he is calling "osteotomy revision".

His procedure note reads:

Prior anterior skin incision was opened and inguinal ligament + Sartorious were retracted medially, taking the LFCN with them, protecting it. Inner ilium was dissected from iliacus muscle bluntly, with a cob and swab. Hematoma and debris were cleared off. Irrigation was done and the central acetabular fragment (CAF) was found to have externally rotated and moved laterally. Retractors were placed and 2 of 3 screws were removed. 2 Shanz screws were placed then in the prior drill holes and attached to a external fixator. At this point remaining screw was also removed and the CAF was mobilized. Manual realignment of the *central acetabular fragment was done and provisional fixation was done with the guide wires for the screws and correction was checked with a intraoperative X ray. This was compared with pre operative x rays and the correction was found to be acceptable. *After confirmation of correction using fluoroscopy in AP and false profile planes, the fragment was fixed with 2-*4.5mm**full threaded*cortical screws and one 6.5 mm fullly threaded cancellous screw. Fixation found to be stable and irrigation was done.
*
Inguinal ligament and Sartorious were attached back to ASIS using 1 vicryl. *Incision was closed according to soft tissue layers using 1 vicryl and 2-0 vicryl.*Skin was closed with*subdermal Monocryl.*Final fluoro shots were obtained to confirm position/correction.

Based off of this note, how would this be billed?

Thank you

Medical Billing and Coding Forum