You Be the Coder: Discover What Constitutes "Total" With Knee Replacements

Question: My provider conducted an orthopedic surgery on a patient’s knee that had a total replacement operation approximately one year prior. During the latest operation, the doctor put in a 15mm [...]

Posted on: 9 May 2017 | 2:05 am

Reader Question: Determine if 20550 Includes Ultrasound Guidance

Question: My doctor conducted an aspiration of a cyst in the back of the right knee using ultrasound to guide an injection used during the operation. My gut is telling me [...]

Posted on: 9 May 2017 | 2:05 am

Reader Question: Looking to Code Injection on the Piriformis With Fluoro? Your Answer is Here

Question: There is some disagreement between my provider and I. For an injection of the piriformis with fluoroscopy, I typically use the code 20552. The doctor however insists that we use [...]

Posted on: 9 May 2017 | 2:05 am

MACRA: Prepare Yourself for Orthopedic Quality Reporting With These FAQs

Embrace MIPS as PQRS wanes. If you think that the expiring Physician Quality Reporting System (PQRS) means your orthopedic practice can forget about “quality reporting,” think again.

Posted on: 9 May 2017 | 2:05 am

Post-Op: 3 Scenarios Will Hone Your Post-Op Infection Coding

Hint: Look to global period and modifiers for your solutions. You could be sabotaging your claims for post-op infections if you aren’t well versed on individual payers’ [...]

Posted on: 9 May 2017 | 2:05 am

Reader Question: Navigate Modifiers 78 and 79 With This Advice

Question: Recently, a patient came to our office for a follow up after he had an arthroscopy on the knee. After observation, he had right knee arthroscopy with recurrent effusion. We [...]

Posted on: 9 May 2017 | 2:05 am

MACRA: Highlight These 21 Quality Measures for Your Orthopedic Practice

Make sure your orthopedic practice continues to get the pay you deserve for Medicare beneficiaries by appropriately reporting specific quality measures. Although most of these were available [...]

Posted on: 9 May 2017 | 2:05 am

You Be the Coder: Check Out Whether Unlisted-Procedure Codes Have Global Days

Question: I was wondering, does Medicare assign a global period for unlisted-procedure codes? For instance, if our orthopedic surgeon performs a core decompression of the femoral head, and we report 27299, [...]

Posted on: 11 April 2017 | 5:04 am

Reader Question: Beware Modifier 'Solutions'

Question: When we see a claims denial in our practice, some of our staff is quick to resubmit the claim with a modifier to “solve” the problem. That doesn’t work so [...]

Posted on: 11 April 2017 | 5:04 am

Reader Question: Arrange Follow-Up with Original Surgeon

Question: We have taken over post operative care on a patient who had surgery from another physician. We want to be sure we are billing only the post-op care. Do we [...]

Posted on: 11 April 2017 | 5:04 am