Orthopedic Coding Alert
Hold Local Medicare to NCDs
Question: Michigan Subscriber Answer: Yes. According to a Medicare FAQ, NCDs are binding on the following: • all Medicare carriers • fiscal intermediaries • quality improvement organizations • health maintenance organizations • competitive medical plans • healthcare prepayment plans. Resource: Remember: Contractors can create their own coverage decisions for items not specifically covered or mentioned in NCDs. You can search NCDs at or find them in the NCD manual at by clicking "Internet Only Manuals" and choosing publication 100-03.
Orthopedic Coding Alert
- Op Note Coding Corner:
Submit Your Hand Surgery Claims to Payers With Confidence Using This Strategy
Don't know what services a CPT code includes? You could be making bundling errors -- and [...] - Clip 'n' Save:
Handle Your Hand, Wrist Fracture Diagnoses With Care by Pinpointing Anatomic Site
Here's how to differentiate the tiquetrum from the trapezium. Orthopedic surgeons dealing with hand procedures [...] - 3 Questions Clear Up Your Modifier 24, 25, 57 Confusion
Applying the correct E/M modifier can boost your bottom line by $100. To avoid denials [...] - Modifier Cheat Sheet:
Banish Your E/M Modifier Phobias Forever
You'll never wonder which modifier applies to minor vs. major procedures. If you're often mixing [...] - You Be the Coder :
Untangle Hardware Removal, Reinsertion Coding
Question: My orthopedist removed posterior hardware at L5-S1 and then decided to do a fusion [...] - READER QUESTIONS:
Dodge G0289, Modifier 22 Mistakes
Question: Our orthopedist did a right knee arthroscopy with extensive tricompartmental synovectomy, partial medial menisectomy, [...] - READER QUESTIONS:
Find Your TFCC Code Here
Question: What ICD-9 code should we use for TFCC (triangular fibrocartilage complex) of the wrist? [...] - READER QUESTIONS:
Sort Out This ER, Then Assumed Care Scenario
Question: My orthopedist treated a patient who was first seen in the ER for an [...] - READER QUESTIONS:
Carrier Can Secure How You Use S-Codes
Question: We have been billing out 27299 for total hip resurfacing but then Regence requested [...] - READER QUESTIONS:
Hold Local Medicare to NCDs
Question: Are National Coverage Determinations (NCD) binding on contractors? Michigan Subscriber Answer: Yes. According to [...] - READER QUESTIONS:
Equate 'Weber B' With Lateral Malleolar Fx
Question: Which CPT and ICD-9 codes should we report when the surgeon dictates a Weber [...]
