Also, the procedure was 29881 and I saw in Supercoder that 53 is an acceptable modifier to bill discontinued procedure for the surgeon, but the modifier I was considering for the ASC side, 74, was not listed. Does anyone know why?
Thank you!!
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 2018 CPC Practice Exam Answer Key 150 Questions With Full Rationale (HCPCS, ICD-9-CM, ICD-10, CPT Codes) Click here for more sample CPC practice exam questions with Full Rationale Answers Click here for more sample CPC practice exam questions and answers with full rationaleAlso, the procedure was 29881 and I saw in Supercoder that 53 is an acceptable modifier to bill discontinued procedure for the surgeon, but the modifier I was considering for the ASC side, 74, was not listed. Does anyone know why?
Thank you!!
Thank you.
I am trying to figure out how to code some arthroscopic procedures and the more I try to figure it out the more I am confusing myself! :confused: If some one could help explain this to me it would be appreciated!!
First – if the doctor does a subacromial decompression along with other procedures (i.e. rotator cuff repair, debridement, etc.) but does not do an acromioplasty can I still use 29826 or does the acromioplasty need to be done to use that code? And if it can’t be used, what code would be used?
Second – my doctors are documenting that they did an arthroscopic Suprascapular nerve decompression at the same time as other procedures (i.e. rotator cuff, debridement, tendodesis, etc.). Is this billed separately or bundled with the other procedures. If it is billable, the unlisted arthro code 29999 would be billed, however what code would this be comparable to?
Any help would be appreciated. I am hoping for an answer as soon as possible as my claim is pending for the right answer!!
Thanks!!
Jodi Dibble. CPC, COC
Post-operative Diagnosis: Bladder clot, extensive papillary bladder tumor over right lateral wall anterior bladder wall and posterior bladder wall, prostatic congestion with bladder outlet obstruction
Procedure: TRANSURETHRAL RESECTION BLADDER TUMOR, FULGARATION OF PROSTATE, CLOT EVACUATION (N/A)
CYSTOSCOPY;BILATERAL RETROGRADE PYELOGRAM (Bilateral)
Findings: 1. Occluding prostate with friable prostate congestion 2. Extensive papillary bladder tumor covering the right lateral wall, anterior bladder wall and posterior bladder wall 3. Bladder clot for. Normal retrogrades
Complications: None, patient tolerated the procedure well.
Summary: Patient was taken to the operating room where he was induced under general anesthesia prepped and draped in a sterile fashion over the genitalia in the dorsal lithotomy position.
Urethra was calibrated with Otis bulb to 28 French without resistance. A 26 French Olympus continuous flow resectoscope sheath with the visual obturator was passed into the bladder under direct visualization.. Findings are as noted above. Orifices were orthotopic with no bloody efflux noted.
Clot was irrigated from the bladder with the bowl evacuator.
Continuous flow resectoscope with a bladder loop was placed into the sheath The prostatic urethra was fulgurated to control bleeding from prominent superficial vessels.
All identifiable papillary bladder tumor was resected from the bladder wall along the the lateral wall on the right, the posterior wall and the anterior wall as encountered. no perforation grossly was encountered. Air bubble remained intact throughout the course of procedure. Margins of resection and base of resected areas were fulgurated
Resected bladder wall/tumor was retrieved with a bowl of evacuator and sent to pathology.
Bilateral retrogrades were shot using a 5 French open-ended catheter. Upper tracts were normal. No filling defects obstruction or stones were noted.
Upon completion there was no active bleeding the instruments were removed and the bladder was drained with a 20 French 3 way Foley catheter passed with the aid of a catheter guide. 30 milliliters of sterile water was placed into the balloon. Return was clear on hand irrigation. The patient was awakened and sent to recovery room stable condition with clear return on CBI.
Estimated Blood Loss: 200 ml clot. Negligible blood loss with bladder tumor resection
Total IV Fluids: See Anesthesia Record
Urine Output: See Anesthesia Record
Specimen(s): Resected bladder tumor
We decided to pull the tube out and put the paper patch there to see if it helps. She felt little better and felt more full as expected, but no crackling sound.
Evacuation of seroma – 10140
Dye Study – 61070
Reprogramming & Electronic analysis of pain pump – 62368
This was performed w/Fluoro… There are no edits for CPT 77002 with any of these codes, but it seems like unless it’s specially in the list of codes since this is an add-on code, it always gets denied.
Procedure report:
The lumbar spine interspace was localized with fluoroscopy. After the skin the was anesthetized with lidocaine 2% and bupivicaine 0.5% equal volumes, using a 25-gauge needle, a longitude incision was then made at skin using an 11-blade. Using a combination of sharp dissection/blunt dissection/electrocautery, the incision was taken through the subcutaneous tissue until the lumbar paraspinal fascia was identified. There was a gush of about 200 ml of clear fluid that came out. There are no signs of infection in the whole area. I could not identify any area of leakage of CSF or any area of leakage from the catheter. We confirmed the patency of the catheter by accessing the catheter access port as follows:
The catheter access port was accessed using the kit provided by the manufacturer. Clear cerebrospinal fluid was then aspirated from the intrathecal catheter confirming that the catheter was patent. Approximately 3 ml was siphoned off. Using a 2-0 Tycron, I took a purse-string suture around the catheter entrance through the lumbar paraspinal fascia.
Positioning of the catheter was rechecked and confirmed with fluoroscopy. Wounds were copiously irrigated. Incisions were closed with 2-0 Vicryl in the subcutaneous layer, 3-0 Vicryl in the dermis, and 3-0 Novafil in the epidermis.
Electronic analysis of the pump was performed to ensure proper functioning. The pump was then programmed to deliver a bridge bolus of the medication to the tip of the catheter and then the pump was programmed to deliver the planned dose and was double checked by two personnel to minimize any errors. I increased the pump to 1.7 mg a day.
TYIA
Manufacturer website:
https://aerinmedical.com/nasal-obstruction-treatment/
My Encoder CPT/Lay description:
Excision or destruction (eg, laser), intranasal lesion – The physician removes or destroys intranasal soft tissue lesions using techniques such as surgical excision, cryosurgery, chemical application, or laser surgery.
Procedure description from Vivaer website:
VIVAER utilizes proprietary low-temperature, non-ablative energy to effectively reshape the nasal airway to improve airflow, without any incisions.
A clear understanding of the procedures surgeons use to diagnose intracranial lesions puts everything into perspective. There are several procedural codes for stereotaxis in the CPT® code book, but only two describe stereotactic biopsy, aspiration, or excision of intracranial lesions with or without computed tomography (CT) or magnetic resonance imaging (MRI) guidance. Upon closer examination, […]
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