CODING HELP!!

[hpalomo]

I don't feel confident coding this at all, would appreciate your help.  This is all the info I have.

28296/correction,hallux valgus (bunion)
28285 (dr put a 59 down,not sure if used correctly)/correction 2nd hammertoe
28270 (dr put a 59 down)capsulotomy 2nd hammertoe
28285 (dr put a 59 down)/correction 3rd hammertoe
28270 (dr put a 59 down)/capsulotomy 3rd hammertoe

This is how I would bill it but it's probably wrong??
28296 (RT)
29285 59,T6
28270 59,51,T6
29285 59,T7
28270 59,51,T7         What do you guys think?   Thanks for your input.

Heather/Tewskbury,MA

[Michele]

Heather,

     I am not a certified coder but I have been exposed to a lot of podiatry coding.  The way you have it appears correct and the 59 modifier does appear to be used correctly.  If the example at the top is what the dr provided, then you are coding it correctly as it was given to you.

[pattil88]

Hi Heather:
This is sort of difficult w/o a copy of the op report but I agree w/Michele. I think your code and modifier selection makes sense based on what your dr selected. You're expanding on his selection by using the appropriate modifiers that s/b involved - you may want to make sure whatever insurance is getting billed accepts the -59 and "T" modifiers. (some have a problem with those....)

Also, go to the AAOS (American Academy of Orthopaedic Surgeons) website (www.aaos.org), go to the upper righthand corner in search and lookup CPT 28296 and there s/b an article that comes back called "Foot & Ankle Coding Overview" dated 5-9-11 that gives some excellent insight into the codes and modifiers involved.

[hpalomo]

Thanks Michele & Patti!

[APruitt2045]

Can anyone help me???

My physician in the medical director of a pulmonary rehab facility. He has to be available for the pts when they are in the lab and he  has to interview patients once a month. He also approves the treatment plan.  Do you know how we can bill for all of this?

[Michele]

I would think that most of his services would be reimbursed in the form of a salary from the facility?  For having to be available?  But if he sees the patients I would think that would be billable as an E&M service depending on what is involved.  I haven't been involved with a situation like this - anybody else have any experience??

[APruitt2045]

Thank you.

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