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Tag Archives: Together

Medical Coding Tools that Tie It All Together

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Free resources that will help you report provider services accurately. Due to productivity demands, medical coders may be tempted to rely on word of mouth for answers to coding questions, rather than to read guidelines, policies, rules, and instructions to substantiate coding decisions. Although seeking the advice of knowledgeable and experienced coders may be necessary […]

The post Medical Coding Tools that Tie It All Together appeared first on AAPC Knowledge Center.

AAPC Knowledge Center

Is it proper to code CPT 31233 (approach) and 31267 (cyst removal) together?

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The physician performed an antral puncture with removal of cyst from the left maxillary sinus. Attempts were unsuccessful through the nose. The canine fossa using a scalpel and a inch drill punch was performed through the anterior wall of the left maxillary sinus. This allowed the endoscope to be passed through the front of the sinus visualizing the maxillary sinus in front of it. A curved biting forcep was then passed through the nose into the sinus and under endoscopic guidance through the antral puncture the cyst was grasped and removed. Would it be proper to code as CPT 31267 and CPT 31233 with a 59 modifier?

Medical Billing and Coding Forum

Assistant Surgeons and Co-surgeons together

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I code for urology, and have a radical nephrectomy surgery case where two of our MD’s performed the nephrectomy together, one was primary, and the other the assistant surgeon. This is what we often see, and will add modifier 80 to the assistant surgeon, however, the patient had some aortic bleeding and a vascular surgeon was also involved in the case, so from a different specialty. I do not know the rules or guidelines on coding for co-surgeons, when there was also an assistant surgeon from our specialty involved in the case.

Normally we would code the CPT code for the primary surgeon, and then code the CPT again for the assistant surgeon with modifier 80.
since there was also a co-surgeon involved from a different specialty, would we add modifier 62 to the primary surgeon’s CPT to support the co-surgeon or is this not allowable when an assistant is also involved; does that "overrule" the assistant surgeon in this case?

Medical Billing and Coding Forum

Exclude 1 notes N85 series can’t be coded together with N86

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Dear All,

Need some help to find why, N85.00 can’t be coded with N86. There is an exclude 1 note in the ICD 10 guidelines; however, while informing our doctors they want to know the reason. Our OB saying, these two conditions doesn’t have any relation, then why we can’t code together.:confused:

highly appreciate your help in this regards,

Thanks a lot

Sherin

Medical Billing and Coding Forum

2019- ban on billing 33860 and 33870 together CT surgery

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Some of my physicians perform the ‘elephant trunk procedure’ which includes replacing the ascending aorta and a total arch replacement with reimplantation of the head vessels. We have a new code for hemiarch but the total arch can no longer be billed with ascending. With this procedure another graft is anastamosed to the distal end of the arch graft so that the descending aorta can then also be replaced by endograft. Ascending, arch and descending aorta are all replaced. Any CT surgery coders out there who think this ban is a mistake?

Medical Billing and Coding Forum

Pain Management and Behavioral Health together?

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Our clinic has started a new pain management program. Present during these visits is a MD, Pharmacist, and a LCSW or ASW from Behavioral Health. There are two separate progress notes that are documented for this one encounter. One from the MD and one from Behavioral Health. The MD addresses the medication and any other concerns while the Behavioral Health documents other behavioral diagnosis. My question is, can we bill for both?

My initial thought is to only bill for the MD since this is only one visit. Do any other Behavioral Health clinics work with a pain management program?

Medical Billing and Coding Forum

22612 and 22633 billed together

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We billed 22633 and 22612 out done at the same date of surgery but on different levels. There is a CCI edit in place that is creating these two codes to bundle even w a modifier. We have changed the code 22612 to 22614 but it has a much lower RVU. Has anyone else dealt with this situation and know of a different code or workaround to get the full RVU for the second level? 22899???

Thank you for your help,
Stephanie

Medical Billing and Coding Forum