Archive for 'Coding Challenge'

Reader Question: Document Donor Site to Code Advancement Flaps

Posted on 12. Feb, 2015 by .

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Question: Our surgeon closed a deep abdominal wall defect that was approximately 440 sq. cm. using 300 sq. cm. flaps on each side. Should I report just the repair, or can I separately code the advancement flaps?

FloridaSubscriber

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Reader’s Question: Swine Flu Out of Pandemic Vaccine List

Posted on 28. Jan, 2015 by .

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Question: Our practice has been receiving queries for H1N1 vaccinations. What are our coding options and restrictions?

New Jersey Subscriber

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Reader Question: Get Clarification on “Dilation” and 58100

Posted on 14. Jan, 2015 by .

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Question: The Feb. 2012 issue of the Ob-gyn Coding Alert has an example of CPT® 58100-endometrial sampling (biopsy) as: “…plastic catheter into the uterus and suctions out a small amount of the endometrial lining.” Dilation is bundled with 58100. If a provider does some cervical dilation along with an endometrial sampling, at what point do we change from coding a 58100, 58120-52 or 58120? I spoke with a provider who uses the plastic catheter suction device and states he does a 360 degree endometrial curettage, after dilating the cervix slightly and sounding the uterus. Another provider uses the same tool and states he does a 360 degree endometrial biopsy, after sounding the uterus and dilating the cervix as needed. Is there a clear CPT® guideline on what is considered a sampling/biopsy and what is considered a curettage? Both of these providers do this procedure with out anesthesia for menorrhagia. 

Iowa Subscriber

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Reader Question: Bill for X-rays and Contrast in Prostate Cystogram

Posted on 18. Dec, 2014 by .

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Question: How should I report prostate cyst aspiration and prostate cystogram? How do we report for the injection of contrast into the prostatic cyst?

Virginia Subscriber

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Reader Question: Stick with 52282 for Permanent Stent

Posted on 10. Dec, 2014 by .

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Question: I saw your article on new 2015 codes 52441 and 52442. Is there a specific code for a permanent intra-urethral urethral stent or prostatic stent? Will I be able to use 52441 and 52442 for those stents?

New Jersey Subscriber

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Reader Question: Don’t Make This $104 Mistake

Posted on 26. Nov, 2014 by .

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Question: Our surgeon removed a mass from a patient’s nose (1.3 cm, including margins), and the pathologist diagnosed it as a dermoid cyst. Should we report 11442 for the service?

Nevada Subscriber

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Reader Question: Select Glucose Code by Method

Posted on 12. Nov, 2014 by .

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Question: We’re getting denials when we bill a blood glucose test with 82962. The payer says that the test isn’t payable under contractual agreement. Is this the correct code?

SuperCoder Subscriber

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Reader Question: Find Out Whose Chart Gets the Fetal Fracture Dx

Posted on 22. Oct, 2014 by .

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Question: Patient was about 6cm and began to have decelerations into the 80’s. They decided to perform an emergency C-section. Because the fetal head was wedged tightly into the pelvis, the ob-gyn had great difficulty in trying to extract the baby. Several physicians attempted to deliver it without success. The incisions, both uterine and skin, were extended into a “T’ shape. Then, they were finally able to get the baby out. When all was said and done, the fetus had a femur fracture. Fetal weight was 6lbs 14oz. 

What ICD-9 code would be appropriate for this scenario, aside from the fetal heart decelerations?

Virginia Subscriber

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Reader Question: Single Lesion Removal Using Different Techniques

Posted on 08. Oct, 2014 by .

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Question: Our internal medicine physician recently performed removal of a plantar wart approximately 5mm in diameter. He initially shaved the lesion and then cauterized it with silver nitrate. He finally injected it with .01 ml of Candida skin test antigen. What CPT® code(s) should I report for the procedure? I am thinking of reporting 11305, 11900 and 17110. Is this appropriate?

Michigan Subscriber

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Reader Question: PPD Test May Warrant E/M

Posted on 24. Sep, 2014 by .

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Question: Our insurance company bundles an office visit with the code for PPD administration and paying one or the other, but not both. Should we file something differently?

North Carolina Subscriber

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