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63047 And 63267 billed in same op session???

I have a neurosurgeon who is trying to send through 63047 and 63267, different levels, same op session. My experience has been with carriers, even with a 59 modifier on 63047, they deny as bundled. Any suggestions or pointers on how to code this? Thank You.

L2-L3 Laminectomy for alleviation of epidural lipomatosis

L3-L4 Laminectomy with bilateral foraminotomies for removal of synovial cyst

L4-L5 Laminectomy with bilateral foraminotomies for severe central stenosis

Medical Billing and Coding Forum

33282 and 33284 same session is it billable with 59 modifier?

Cardiac Implantable Loop Monitor Explant Operative Report
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Procedure(s): Implantable Loop recorder explantation
Implantable Loop recorder implantation
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Indications:
Loop ERI
Palpitations
Cryptogenic stroke
PAT
Inducible but not clinical PAF
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Procedure Details
The risks, benefits, complications, treatment options, and expected outcomes were discussed with the patient. The patient and/or family concurred with the proposed plan, giving informed consent. Patient was marked and timeout done.
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The antibiotic was completely infused. The patient was prepped and draped in the usual sterile fashion and the left lower parasternal region anesthetized with 10 cc of 2% lidocaine with epinephrine. An incision was made over the old scar, and dissection made down to the loop device, and the pocket incised and loop removed. The insertion tool of the new device inserted the loop parallel to the old loop pocket in a new site. Hemostasis was insured. The incision was closed with steristrips.
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Steri-Strips and a dry sterile dressing were placed over the wound and the patient was transferred to the heart center holding room in stable condition for recovery from sedation.
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I was present with the patient for the duration of moderate sedation and supervised airway monitoring staff who had no other duties and monitored the patient for the entire procedure. Details of sedation and monitoring are entered by the nurse administering the sedation into the EP lab EMR. Please see the nursing flow sheets for documentation of the name of the independent trained observer, and intra-service start and end times.
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Hardware explanted: Medtronic Reveal LINQ MN LNQ11, SN RLA685634S
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Hardware implanted: Medtronic Reveal LINQ MN LNQ11, SN RLA497302S
should I bill 33282-59,33284?
patient has medicare
thanks in advance
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Medical Billing and Coding Forum

E/M Update Opinions Shared at Listening Session

A representative from the Hospital and Ambulatory Policy Group at the Centers for Medicare & Medicaid Services (CMS) held a listening session regarding proposed updates to the documentation guidelines for evaluation and management (E/M) services on March 21st. The listening session was to get feedback from stakeholders on policy proposals for upcoming notice and comment […]
AAPC Knowledge Center

22633/63047 same interspace same session same day 2 different specialities

Can anyone find the most up to date article from Medicare giving instruction on how to bill these codes If Neuro specialist Dr. A bills 63047 and Spine specialist Dr. B bills 22633. Should this be a co-surgery or is it appropriate for them to bill their own codes separately even though these are bundled codes per CCI edits? Hoping someone can help. I have researched every resource I have. thank you

Medical Billing and Coding Forum

22633/63047 2 different specialties same interspace same session same day

Can anyone help me find the most up to date medicare guidelines on this.
Neuro Dr. A bills 63047 and Spine Dr. B bills 22633. Should this be a co-surgery or is it appropriate to bill the codes separately even though it is bundled per CCI? If anyone has a great link explaining this i would greatly appreciate it. I have exhausted my resources. thank you.

Medical Billing and Coding Forum

Billing a psychotherapy session with an E/M code 90832, 90833, 99212

I am trying to bill a psychotherapy session along with a medication management office visit. When billing add on code 90833, which code can be listed as the primary procedure? Should I bill 90832 with 90833 as the add on, or can we use 99212-15 as the primary procedure and 90833 as the add on code? Please advise

Thanks!
-Kristin

Medical Billing and Coding Forum

Bilateral TAP blocks AND Bilateral Rectus Sheath blocks duting same session

Hi,

Provider performed both Bilateral TAP blocks single injections, and Bilateral Rectus Sheath Blocks, single injections. Has anyone had any experience coding for both and not getting it denied?
how would it be billed? 64488-XE, 64488-59 ?? Keep in mind this will be billed w/ 00752 as well.

Thanks,
Ellie

Medical Billing and Coding Forum

upper gi and colonoscopy same session

I’ve always been under the impression that if these two procedures are done at the same session, modifier -51 isn’t utilized on the second procedure, (i.e., 45380 + 43235) because they are from two different endoscopic families, with different base codes. I’m now being told I’m incorrect, and that a modifier -51 is required. I’m curious as to how other GI coders handle these scenarios. I’ve never used any modifiers of any kind when coding these together.

Medical Billing and Coding Forum

spinal instrumentation insertion and removal within same operative session

help !!

my surgeon has input bilateral pedicle screws at l2-l3 and has then removed the right side screws due to them migrating during the surgery . the dr is wanting to bill 22840 for the insertion and then also 20680 for the removal. I know am almost 100% positive 20680 is a completely wrong code and i really don’t think you can bill for that removal since its within the same session. i am having trouble finding anything in black an white to discuss with my dr. if anyone can please provide me some links or any insight would be appreciated

thank you

Medical Billing and Coding | AAPC Forum