Fibrin sheath disruption

I'm struggling coding fibrin sheath disruptions.


FIBRIN SHEATH DISRUPTION

How would I code this? Following discussion, written informed consent was obtained for the procedure. The right groin was sterilely prepped and draped. Right femoral TempCath was exchanged for a 10 French sheath. The inferior vena cava was empirically dilated to low pressure with a 12 mm balloon to disrupt any potential fibrin sheath. The sheath was exchanged for a 24 French Schon TempCath which was placed with...

Fibrin sheath disruption

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pre-SIR-Spheres mapping procedure

Asking for advice in this scenario;

PROCEDURE:
* Selective angiography of the superior mesenteric, celiac and left
gastric arteries.
* Superselective angiography of the right and left phrenic artery.
* Superselective angiography of left hepatic artery, right hepatic
artery, 5/8 hepatic artery and subsegmental branches.
* Injection of Tc-99m-MAA into the left hepatic artery, and
subsegmental segment 8 hepatic arteries.
* Closure of...

pre-SIR-Spheres mapping procedure

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Ortho question

Can 29879 be billed with 29876 without modifier 59 ?

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Billing 96127 & 99406

Good Morning!

I have previously billed 96127 and 99406 together on same day with E/M, and only 1 was paid. I put 25 modifier on E/M. I also put the appropriate dx on each one. Should these both be paid on the same day as E/M? If they are, what modifier on which? if not, can you point me in the direction as to where it says they can not be billed together? I have tried every way I can think of and no insurance has paid for this in the past. I would appreciate any help! Thanks in advance!

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help with a dx please

primary may be skin of neck , but not documented

thank you

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Coding Partial Mastectomy and adjacent tissue transfer

I have done a lot of reading and I can't positively verify if you can code the adjacent tissue transfer when done along with a partial mastectomy. The doctor was even specific on the dimensions. But I read in a couple articles that closure techniques were included in the procedure 19301.

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CPT for repair of small spleen laceration

Hello all,

I am looking for a CPT for cauterizing the lower pole of the spleen capsule. Was looking at 38115 but that seems too much for what was done:
With the open abdomen and examination of the spleen, were able to cauterize the lower pole of the spleen by placing the electrocautery to 100 and cauterize the capsule of the spleen, then placed some Surgicel SNoW, which appeared to be an adequate hemostatic agent.

Any thoughts/suggestions greatly appreciated.

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Does Payer need to know Provider's ASC locations?

Do I need to add and an ASC as a 'location' in order for insurance to pay professional fees billed by doctor? In other words, we have to notify payers of each office location the docs works at, but do we need to notify them of each ASC location? I know we do not need to notify of hospital locations or assisted living facilities, not sure about ASC. tx

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EEG CODING

CAN CPT CODE 95816 BE PERFORMED IN CONJUNCTION WITH CPT CODE 95715 ON THE SAME DAY?

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29806 - Superior Capsular Reconstruction

Hi, the surgeon wants me to code this surgery with 29806 and I don't think the documentation justifies that. Help!

Description of Procedure(s):

Patient was taken the operating the supine position after excellent general anesthetic patient was placed in semisitting position right upper extremity clearly shoulder was prepped and draped in usual sterile fashion. Shoulder was placed through passive full range of motion there is no instability. Right shoulder was arthroscoped with a 25 degree...

29806 - Superior Capsular Reconstruction

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Most Valuable Resource

Hi, everyone. I'm new here. Just recently passed my CPC exam. I would like to know what your most valuable resource is for coding.
I have limited funds, so I want to make sure whatever I might purchase is well worth the money.

I would also like to know how often you replace your coding books.

Thanks so much!

Mary

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Periprosthetic fracture with ORIF

is this 27236? the fracture is in the shaft

POSTOPERATIVE DIAGNOSIS: Right hip periprosthetic fracture. PROCEDURE PERFORMED: 1. Right total hip arthroplasty revision. 2. Open reduction and internal fixation, right femur. IMPLANTS USED: 1. Stryker MDM liner to fit 54 mm cup. 2. Stryker restoration modular cone/conical construct with 15 x 155 conical stem and 23+0 proximal body. 3. A 28 mm Biolox +4 femoral head with X3 outer...

Periprosthetic fracture with ORIF

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External cause reporting

Hi,
What are the T codes not to report with external cause codes?

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Colpopexy, Colporrhaphy

Hello Fellow Coders, I am new to OB/GYN and got very puzzled by this short Op note: trying to understand what was done to match CPT available. I will greatly appreciate your help!
MD provided codes 57260 and 57282. I read the descriptions of all available CPT, I googled a lot about POP, compiled some information but nothing has helped me to find straight-forward CPT. It even does not tell me what organ has prolapsed, just the stage. It seems like the only 57282 was done. Thank you very...

Colpopexy, Colporrhaphy

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CPC exam results 2020

I took the CPC certification exam on August 1st and I still haven't heard if I've passed or not and today is August 17th. Does anyone know how long grading is taking due to COVID-19?

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Online exam - failed

Hi everybody!
I took exam on Sunday night and Monday morning.
This is my fault, I knew, I was not fully prepared. I was taking practice exams through CCO, and was getting 65% and less. I just decided to take exam anyway. Honestly felt tired to be all the time in a phase of preparing to the exam.
So, my first part of exam was on Sunday, at 8pm. Before exam starts proctor reads rules, reminder - you cannot leave room, you have to have external cameras, no one allowed to enter the room, etc. I...

Online exam - failed

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MDM Leveling Question for outpatient Physician Coding

I have a general question when trying to figure out MDM level. If I calculated my problem and data points and I have a High, Low and Moderate Complexity level. Which one do I choose?

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CPMA credential--Study team-mates out there?

Hi. I am taking the exam yet this year. Wondering who else is and how they are doing. Could use support and would like to also give some!

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Replacement codes

What are the replacement codes for CPT 75280 and 75920?

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Telehealth????

I have a Neurologist who is new to our practice and he wants to bill everything Telehealth, he is wanting to provide Telestroke services, critical care, phone visits, Initial Inpatient Visits, Subsequent Visits. I have read the lengthy Cares ACT and I still have so many questions about Telehealth.
1. I am looking for documentation guidelines for codes G0508 and G0509? How do they differ from 99291 and 99292?
2. Can you bill the 99441-99443 codes for a telephone E/M service provided for a...

Telehealth????

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Removal of voice prosthesis

Procedure(s) Performed: Debulking Granulation ball and removal of indwelling voice prosthesis

Diagnosis: airway obstruction due to granulation tissue mass and indwelling voice prostheses partial extrusion

Description of Procedure(s):
Pt to OR - Positioned and draped - time outs performed - Pt s/p laryngectomy stomal airway 85% obstructed with extruding prostheses and granuloma ball - With trach collar an iv sedation and lidocaine in airway - the granulation ball and prosthesis was removed...

Removal of voice prosthesis

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Data Points/Independent Vis/Test billed profee on same day

Hello from California

Cardiology MD billed: 99214 + 93000.

List of lab results in side-header of clinic note - no mention in note of "I reviewed...".
Previously performed echo reviewed in chart, but not documented whether this MD performed/billed that previous echo or not. (would query)
EKG performed in clinic that day, read and billed by same MD.

4+ stable chronic diagnoses addressed, and nothing ordered other than the EKG which was performed and billed by MD same DOS, with...

Data Points/Independent Vis/Test billed profee on same day

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31020?

I've attached a redacted operative report, if someone can tell me if you would use 31020 for the underlined area on page 2. Thank you!

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Looking for a medical coding position OR a chance to get more coding experience

I have been looking for opportunities to use my education and acquire experience.

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Redo ORIF 5th metatarsal base

Good morning, I need help in coding both CPT and ICD-10 codes. I have a patient that had a non union of her 5th metatarsal base. I did an ORIF on it, 2 weeks after surgery she didn't listen to me concerning her non weight bearing status, she fell and broke the entire repair apart.

I need advice on what code I should use, what diagnosis as well as any modifiers needed to redo and re-bill this procedure.

Thanks Dr Buccilli

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Incident to billing

We bill incident to billing for our NP & PA for new pt's and new pt preventive visits to all insurances to all insurances except Medicare. When billing a NP or PA new pt visit/preventive as incident to for other carriers than Medicare don't the CMS incident to guidelines apply to that carrier also?

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Online exam - failed

Hi everybody!
I took exam on Sunday night and Monday morning.
This is my fault, I knew, I was not fully prepared. I was taking practice exams through CCO, and was getting 65% and less. I just decided to take exam anyway. Honestly felt tired to be all the time in a phase of preparing to the exam.
So, my first part of exam was on Sunday, at 8pm. Before exam starts proctor reads rules, reminder - you cannot leave room, you have to have external cameras, no one allowed to enter the room, etc. I...

Online exam - failed

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Methylmethacrylate

Can you bill for this service if it is used in a fusion? would you code 22853?

Thank you ,
Stephanie

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Change of Chait Appendicostomy with Fluoroscopy

I need some advice on a code. My provider performed a change of Chait appendicostomy with fluoroscopy and the code that is being used is 49450. I think there should be an unlisted code 44979. See op note below.

Procedure:
The patient was identified and placed in the supine position on the operating table. 　Adequate anesthesia was induced. 　Timeout was performed and all present were in agreement. 　The existing Chait tube was removed with steady traction and after placing the obturator and...

Change of Chait Appendicostomy with Fluoroscopy

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Hi

Hi iam not able to edit my personnel information like mail id and phone number wt to do
And also iam not getting any mails from aapc

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flouroscopic guidance denial

Hi there, I am not very familiar with billing in pain management procedures and we received a denial I am unsure about. We billed in this order:
77002-59 ( all with G58.8)
64420-RT
64421-RT
J1020

The denial states "the related or qualifying claim/service was not identified on this claim"
I have looked everywhere, but don't see any exclusions on billing these codes together. Can anyone offer any insight?

Thank you

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Giving up coding

I’ve had my CPC since 2017 and I’ve yet to actually work as a coder for the reason being that a lot of companies want experienced coders. I’ve kept up with my CEU’s and always kept my certification current however I’m having 2nd thoughts of renewing this year in April as I feel like I’m going to waste my time again.
Any similar experiences? What can I do? I really don’t want to give it up but the coding employment doesn’t look promising for me

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