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Hip Scope Coding Direction

How would this be coded? and codes to compare the unlisted codes to if it goes that way?

Left hip arthroscopic acetabular rim trimming, Left hip arthroscopic femoral head oseteochondroplasty, left hip arthroscopic labral debridement, left hip arthroscopic iliopsoas tendon lengthening, left hip endoscopic iliotibial band lengthening and trochanteric bursectomy?

Thank you all for your help.

Medical Billing and Coding Forum

Scope of Medical Acupuncture?

In case you are wondering how many sessions you will need, it will depend on the case of each person. There is no such thing as a template for the medication of a person’s illness. Surprisingly, serious conditions would require fewer visits because there is the danger of overdoing it. As soon as you enter a needle, there are a series of chemicals that the body triggers in response to the needle. These blend of chemicals span a wide range of effects since they are never the same. It all depends on the area of the body where the needle was inserted.

The succeeding treatments will mean more specific application to your unique illness compared to a generalized diagnosis at the start of the treatment. The in depth knowledge of your body’s reaction will allow the physician to fine tune the method of treatment. The second type is the dense type which is known for sticking to the walls of arteries and causing arteriosclerosis which can exacerbate high blood pressure. In regards to his diet, I advised him on cutting back on his coffee intake as well. Next is the subject of health insurance covering acupuncture treatments is another misconception. Health insurance companies are only going to cover diseases treated with acupuncture by a medical doctor who is a certified acupuncturist.

The first reason to make acupuncture your choice of treatment is that it uses a holistic view of looking at the body rather than each organ and each disease as a separate entity. When you appear for your first visit, your main complaint is addressed along with your lifestyle, diet, emotional factors, and other signs and symptoms. For those who are interested in seeking out this remedy, it is always wise to take certain precautions and select an acupuncture practitioner with utmost care and discernment. After all, there are still some potential risks in the process.

Acupuncture is done by having very thin needles inserted into the skin at certain points on the body. Traditional Chinese theory asserts that placing these needles helps to free up the flow of energy (called chi) through the body. Inserting the needles helps the energy flow to re-balance itself, leading to greater overall well-being. At this point, think of your standard garden hose. If a backyard hose is twisted, it can’t offer an ample amount of water to a plant. Sooner or later, the plant will be incapable to thrive and cultivate. Similarly, an obstacle in the meridians will hamper the amount of qi necessary to nourish your body’s cells. All you have to do is unblock the flow of energy and the body will heal itself. That is why acupuncture is so effective in treating pain. We choose the meridian that is affected and do specific points that affect that meridian. The acupuncture stimulates the key points on the meridian and opens up circulation again.

Doctors usually recommendmedical induction, although it has been shown that it does not always work, and it might even put yourself and your baby at risk. So what to do at this point? I was in the same situation before my baby was born, when a friend of mine recommended that I look into inducing labor with acupressure.

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Orthopedic Coding Rules: Master the ‘Multiple Scope’ Rule

If your orthopedist carries out several procedures during a knee arthroscopy on the same patient on the same day, you will need to understand the multiple-scope rule to determine which procedures you can actually claim and get the payments too.

Vital orthopedic exception: Remember that the multiple-scope rule applies mainly to shoulder and knee procedures in the orthopedic practice; however it also affects those of the elbow, wrist and hip. On the contrary, it doesn’t apply to ankle or metacarpophalangeal (MCP) arthroscopy, and it does not affect arthroscopically aided procedures (29851, 29855-29856, 29888-29889 and 29892).

Follow these expert-approved tips to clinch your coding every time

1. Look to CPT for scope ‘families’

Prior to worrying about how to apply the multiple-endoscopy rule, you should first know why and when it applies.

The multiple-endoscopy rule is Medicare’s method to avoid paying twice (or more) for ‘inclusive’ services by reimbursing only a portion of any scope carried out at the same time as another scope of the same basic type.

2. Always include the ‘base’ procedure

Let us assume that the doctor has carried out a diagnostic shoulder arthroscopy (29805) plus shoulder arthroscopy for repair of SLAP lesion (29807). How does the multiple-scope rule apply?

Remember that family codes always include the work involved in the base code, and a surgical scope always includes the diagnostic scope of the same type. As such, you would report only 29807 in this case.

What about diagnostic shoulder arthroscopy followed by arthroscopic limited debridement? Once more, you should report only the more extensive procedure – in this case, 29822 (Arthroscopy, shoulder, surgical; debridement, limited).

3. Bill both scopes if there’s no base procedure

If the surgeon carries out two scopes in the same family, neither of which is the base procedure, you should go for both codes. As such, if your orthopedist carries out shoulder arthroscopy with foreign-body removal (29819) followed by shoulder arthroscopy for complete synovectomy, you would submit both 29819 and 29821 (… synovectomy, complete).

4. Watch your reimbursement

Under the multiple-scope rule, Medicare will pay the entire fee schedule amount only for the highest-valued scope in a given code family during the same operative session. Medicare carriers will reimburse any additional scopes in the same family by subtracting the value of the base scope in that family and paying the difference.

For more details on this and for other orthopedic coding updates, sign up for an audio conference and stay informed.

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Scope appy w/ umbilical hernia repair

Would like you thoughts on this: Surgean makes umbilical port incision, inserts scope, encounters an incarcerated umbilical hernia. Repairs this without mesh. Proceeds with the laparoscopic appy which is uneventful. CCI edits allows 49653 (hernia repair) and 44970 (appy) in that order.
My quandary is; incision is made in the umbilical area for the scope port, and that incision is repaired on the way out as a matter of procedure, so would these would these two codes be correctly billed together, or is this one of those times that CCI might not provide the best guidance?
Thanks,
Chuck, CPC

Medical Billing and Coding