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Billing for ICG Dye
The surgeon did a robotic/laparoscopic cholecystectomy and cholangiogram with ICG and firefly identification of biliary anatomy. He billed a 47563. Can he can bill separately for the icy green and firefly dye?
Question:
The surgeon did a robotic/laparoscopic cholecystectomy and cholangiogram with ICG and firefly identification of biliary anatomy. He billed a 47563. Can he can bill separately for the icy green and firefly dye?
Answer:
Billing for indocyanine (ICG) or Firefly TM fluorescence is bundled into 47563 laparoscopic cholecystectomy with cholangiogram and is not separately billable.
*This response is based on the best information available as of 06/02/22.
Coding for a Hospital Visit
I was at your conference this past weekend and I was wondering if you could clarify something for me. When a physician sees a Medicare patient in the hospital, and it is their first time seeing the patient however they are NOT the admitting physician, they can only bill a subsequent visit or consult code depending on what the payor allows and documentation correct? Thank you for your assistance.
Question:
I was at your conference this past weekend and I was wondering if you could clarify something for me. When a physician sees a Medicare patient in the hospital, and it is their first time seeing the patient however they are NOT the admitting physician, they can only bill a subsequent visit or consult code depending on what the payor allows and documentation correct? Thank you for your assistance.
Answer:
If the physician is seeing the patient in the hospital for the first time even though he/she is not the admitting physician based on appropriate documentation, an initial hospital visit code (99221-99223) can be billed as long as all three key component requirements are met. If the minimum requirement for the initial hospital care code is not met a subsequent hospital visit can be reported. Keep in mind Medicare does not pay for consultations.
*This response is based on the best information available as of 06/02/22.
Bilateral Carpal Tunnel Procedures – Different Days
We are going to be doing bilateral carpal tunnel procedures on a patient – the right side will be done first then the left will be done 8 weeks later. Should I use modifier 58 (staged procedure) on the 2nd procedure?
Question:
We are going to be doing bilateral carpal tunnel procedures on a patient – the right side will be done first then the left will be done 8 weeks later. Should I use modifier 58 (staged procedure) on the 2nd procedure?
Answer:
Actually, it’s best to use modifier 79 (unrelated procedure in a global period) because the left side (2nd procedure) is unrelated to the right side (1st procedure). Be sure to use the laterality specific ICD-10-CM codes – G56.01 (Carpal tunnel syndrome, right upper limb) and G56.02 (Carpal tunnel syndrome, left upper limb) – for the respective procedures.
Approved Telehealth Platforms
Now that we aren’t limited to HIPAA compliant software, can we use any app or platform to conduct a telemedicine visit?
Question:
Now that we aren’t limited to HIPAA compliant software, can we use any app or platform to conduct a telemedicine visit?
Answer:
During the public health emergency (PHE), you may use any app or platform that is not “public facing” according to HHS. Platforms such as Facebook Live, Twitch, and TikTok are considered public facing. Skype, FaceTime, Facebook Messenger Chat, and Google Hangouts video are all approved platforms.
CPT code 10080 versus 10081
I am trying to code an I&D of a pilonidal cyst. CPT 10080 is simple and 10081 is complicated. How to do I know which code to choose?
Question:
I am trying to code an I&D of a pilonidal cyst. CPT 10080 is simple and 10081 is complicated. How to do I know which code to choose?
Answer:
Great question, you would report CPT 10081 (complicated) if the procedure requires marsupialization, approximation of the wound’s edges, and/or primary closure.
*This response is based on the best information available as of 06/02/22.
Billing Additional Pre-op Visit
Since we have to bring the patients back in for COVID testing and H&P for Joint Commission, can we bill for this visit even though it’s another pre-op visit?
Question:
Since we have to bring the patients back in for COVID testing and H&P for Joint Commission, can we bill for this visit even though it’s another pre-op visit?
Answer:
Yes, since the original surgery was canceled and is now under consideration for rescheduling due to the pandemic and needs to be seen for a COVID swab prior to surgery, which is an indication for charging a new visit (as a health status change)
*This response is based on the best information available as of 06/02/22.
