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Laparoscopic Colpopexy and Cystocele (anterior) and Rectocele (posterior) repair

Can someone please help me with this confusion. I have been coding these for years and for some reason, this particular OP report has me needing a little assistance. Am I missing something or is the cystocele and rectocele repair not clear in this report? This physician also does the A/P repairs vaginally so I am not used to seeing the entire surgery performed Laparoscopically, therefore I don’t know if 57260 is appropriate because the description is vaginal approach. I doubt this would be unlisted unless she is just not clear in this report and that is why I am not confident about billing the A/P repair. So here goes:

https://www.aapc.com/memberarea/foru…2&d=1549055818
OPreport.jpg

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Medical Billing and Coding Forum

Posterior capsulolabral reconstruction

Good afternoon,
I have a coding situation that I need some assistance with. Does anyone know the cpt code for a posterior capsulolabral reconstruction? I’m thinking I may need to use an unlisted code 29999 but I also see some 29806 for the posterior. Any suggestions would be greatly appreciated.
Thanks
Donna

Medical Billing and Coding Forum

Question on posterior cervical spine fusion

I am having trouble finding some info on cpt codes to use for a posterior cervical spine fusion. The fusion was performed on C1-C2-C3. Physician requested the coding to be 22595,22614,22840,61783,20936. Unfortunately, 22614 is not the add on code for 22595 Arthrodesis, posterior technique, atlas-axis (C1-C2) , and while researching, I found there is no add on code for 22595. The only article I have found regarding this subject stated that you could use 22600 Arthrodesis, posterior or posterolateral technique, single level; cervical below C2 segment when you bill 22590 Arthrodesis, posterior technique, craniocervical (occiput-C2). Is it appropriate to use the 22600 code with 22595? Encoder is allowing it with a 51 modifier, but I am not sure if it is appropriate to bill.

Medical Billing and Coding Forum

Anterior & Posterior capsulorrhaphy

I read an interesting AAOS article ( https://www.aaos.org/AAOSNow/2018/Ma…=email&ssopc=1 ) recently, and wondered about this:

Code 29806 covers both anterior and posterior capsulorrhaphy. If a repair is done both anteriorly and posteriorly, it would be coded as 29806-22. The modifier 22 signifies more work than usual.

I’ve never heard that we could use a 22 mod for this- I had assumed payment for 29806 covered anterior and/or posterior repairs. I haven’t seen this advice elsewhere. Has anyone been coding it this way? What are your thoughts on this?

Medical Billing and Coding Forum

Posterior 22612 and anterior 22558 approaches performed together

I have a surgeon who is questioning why they do not get reimbursed 100% for both codes as they were performed with different approaches. Would insurances accept an appeal based on this or do we just have to accept the multiple procedure reduction on the second code? Thanks in advance for any answers.

Medical Billing and Coding Forum