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Click here for more sample CPC practice exam questions and answers with full rationale

Spine surgery

Please help with CPT codes: C4-C5 cervical stenosis
1.Arthrodesis via anterior interbody technique C4-C5
2.Application of intervertebral biomechanical device C4-C5
3.Anterior instrumentation C4-C5
4.Intraoperative microscope

Through transverse incision centered above clavicle left side of cervical fascia. First performed deskectomy at the C4-5 level back to level of uncovertebral joints. this performed without incident and a complete decompression was performed after taking down stenosis at the C4-5 level posteriorly at the level of the spinal cord proper and the exiting nerve roots. Next, using DePuy guide, I placed a size 7 bone dowel acting as intervertebral biomechanical device at the C4-5 level. anterior instrumentation consisting of a skyline plate was placed across the C4-5 level. anterior instrumentation was then deployed through the plate and final locking was performed.

Medical Billing and Coding Forum

Spine codes 72081 – 72084

I am still confused about the spine codes 72081-72084. I was wondering how to count the number of views. For example, today we did a 5 view C spine, 2v T spine (AP/Lat) 4v L spine (AP/Lat/Obliques) and 3v sacrum/coccyx. Would you code this as 72083 – 1 AP of the entire spine and 1 LAT of the entire spine PLUS Obliques of L spine for a total of 4 views? I didn’t count the C spine and the sacrum views since the CPT code description says "if performed" and I don’t think you are supposed to count the T and L spine views separately. How is the radiologist supposed to dictate this? 4 separate reports or one report? This was not a scoliosis study. Thank you

Debby

Medical Billing and Coding Forum

Paradigm Spine Agrees to Resolve False Claims Act Allegations

Recently, the US Department of Justice made an announcement that Paradigm Spine has agreed to resolve false claim accusations levied against it concerning the coflex-F® device. The department has stated that Paradigm Spine has allegedly provided its health care providers with incorrect information on claiming reimbursement for the coflex device.

Read the full article here: https://www.justice.gov/usao-md/pr/paradigm-spine-agrees-resolve-false-claims-act-allegations

The post Paradigm Spine Agrees to Resolve False Claims Act Allegations appeared first on The Coding Network.

The Coding Network

Paradigm Spine Agrees to Resolve False Claims Act Allegations

Recently, the US Department of Justice made an announcement that Paradigm Spine has agreed to resolve false claim accusations levied against it concerning the coflex-F® device. The department has stated that Paradigm Spine has allegedly provided its health care providers with incorrect information on claiming reimbursement for the coflex device.

Read the full article here: https://www.justice.gov/usao-md/pr/paradigm-spine-agrees-resolve-false-claims-act-allegations

The post Paradigm Spine Agrees to Resolve False Claims Act Allegations appeared first on The Coding Network.

The Coding Network

Paradigm Spine Agrees to Resolve False Claims Act Allegations

Recently, the US Department of Justice made an announcement that Paradigm Spine has agreed to resolve false claim accusations levied against it concerning the coflex-F® device. The department has stated that Paradigm Spine has allegedly provided its health care providers with incorrect information on claiming reimbursement for the coflex device.

Read the full article here: https://www.justice.gov/usao-md/pr/paradigm-spine-agrees-resolve-false-claims-act-allegations

The post Paradigm Spine Agrees to Resolve False Claims Act Allegations appeared first on The Coding Network.

The Coding Network

Entire spine x-rays vs individual codes for c spine, t spine and l spine

I was wondering if anyone had information regarding billing the entire spine X-ray codes vs billing the individual codes for C-spine, T-spine and L-spine X-rays?
Our radiology practice normally codes each body part separate, unless they are performing the scoliosis study. Is there any specified rule for this? I assumed that the entire spine codes were coded when the entire spine was included in each view, and the individual codes were coded when the X-rays were just focused in on the C spine, T spine, and L spine.
Example:
C spine 3 views 72040
T spine 2 views 72070
L Spine 3 views 72100
Insurance paid on 72100, and did not pay the others stating it was included in the primary procedure.

Would it be correct to code 72040, 72070 and 72100 on a claim? Or should it be coded 72084?

Any info or reference material would be greatly appreciated.
Thanks!

Medical Billing and Coding Forum | AAPC