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CPT

CPT Code: Removal of Screw
Coding

CPT Code: Removal of Screw

by Michael Warshaw, DPM, CPC

A patient had a first metatarsophalangeal joint fusion/arthrodesis performed. Approximately 1 month following the procedure, one of the screws that was used to perform the procedure backed out of the bone and the plate that was applied to the 1st MPJ and started to apply pressure beneath the underlying skin at the site of the surgical incision. The screw needed to be removed. What would be the most appropriate CPT code to bill?
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Coding

Updates Regarding CPT codes 11730 and 11750

by Michael Warshaw, DPM, CPC

Updates Regarding CPT codes 11730 and 11750
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Coding

Definitions for the Elements of Medical Decision Making

by Michael Warshaw, DPM, CPC

CPT® has provided numerous definitions to clarify terms in the current guidelines, such as “chronic illness with exacerbation, progression or side effects of treatment,” and “drug therapy requiring intensive monitoring for toxicity.”
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Coding

Proper Use of the 59 Modifier

by Michael Warshaw, DPM, CPC

Proper Use of the 59 Modifier
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Coding

What are the Postoperative Global Periods and What is Included in them?

by Dr. Michael Warshaw, DPM, CPC

Minor Surgery: Any CPT code that has a Global Period of “0” or “10” days is classified as a Minor Surgical Procedure. Major Surgery: Any CPT code that has a Global Period of “90” days is classified as a Major Surgical Procedure.
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Coding

Diagnosis Code for CPT 11719

by Dr. Michael Warshaw, DPM, CPC

“What diagnosis code should be used for CPT 11719, NON-dystrophic toenail debridement?”
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Coding

Baffled With Bilateral Biopsy

by Dr. Michael Warshaw, DPM, CPC

“I have a simple question for which I have not been able to find the correct answer. I have a Medicare patient whom we took to the operating room to remove 3 skin lesions. Two were removed from the left foot and one was removed from the right foot. We used code CPT 11421 and are planning on billing the following way: CPT 11421 – 50 (2 units, one lesion on the LT and one the RT) CPT 11421 – LT (the other lesion on the LT) I checked CCI edits and it says I do not need to use a 59 modifier but I feel like I should. Some people have said to use XS modifier. Some have said to bill one code 3 units and others to bill 11421 3 times. What’s the correct answer?”
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Coding

Issues with the Radiology Department

by Dr. Michael Warshaw, DPM, CPC

“My clinic is at the local hospital. I send X-rays to the radiology department. They are eventually read by a radiologist. However, I actually evaluate the x-rays and interpret them myself. Can I bill that component of the radiology fee? And if I do, will it affect radiologist reimbursement?”
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Coding

Complicated Toenail Surgery

by Dr. Michael Warshaw, DPM, CPC

“I have a rheumatoid patient with a grossly deformed interphalangeal joint with significant osseous malformations leading to a chronic ingrown toenail on the hallux fibular border. I have ruled out any infection, osteomyelitis, or neoplasm. The bone is grossly hypertrophic and needs excision along with the nail structures on the fibular border. There also may need to be some plastic closure performed. What are the appropriate ICD10 and CPT codes reflective of this scenario?”
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Coding

Injection Denials

by Dr. Michael Warshaw, DPM, CPC

“I have been getting denials from BCBS, First Care, Aetna, and UHC on claims billed out with diagnosis codes M72.2, M71.571, M71.572, M77.31, and M77.32. Has anyone else had this problem lately? The NDC number and the description are on the claim. The claim is going out as follows: CPT 99213 25, CPT 20550 RT, CPT 20550 LT, J0702 x 2 units, J1030 x 2 units.”
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