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Closure After a Partial Mastectomy, Code 19301
Adjacent tissue transfers, 14000 series to include 14301 and 14302 with 19301 Mastectomy. I see where you clarify 14000 (ADJ flaps) to eliminate dead space is inherent to a mastectomy procedure. My question is does this include codes 14301 and 14302? I'm asking because there was a Q & A 2017 CPT Assistance Article stating "14000 and 14001 are not reported separately because simple, intermediate and complex layered closure is included in the work represented by code 19301". As such, our guidance is that it is ok to bill separately for codes 14301 and 14302 with 19301 when the defect is larger than 30 sq cm.
Injections and E/M Visits
How do you code for an unplanned injection as well as the E&M service necessary to make the decision to perform the injection?
0232T
Hi. We would like a little guidance on what is included in the PRP code 0232T. If the PRP injection is rendered in a tendon and a tendon fenestration/tenotomy is performed, is the fenestration included in the PRP code? Also if PRP is being utilized to hydrodissect a tendon, is the hydrodissection included in the PRP injection?
63267 or 22102?
A patient presents with lumbar discitis and osteomyelitis, and the provider performs a laminectomy with debridement of the disc and bone. Which CPT code is more appropriate in this scenario: 63267 or 22102?
Pediatric ENT Consultation
Our internal compliance team states that our pediatric otolaryngologists should never bill for a consultation. This is because the description in the 2025 CPT states "Services that constitute a transfer of care (i.e. are provided for the management of the patient's entire care or for the care of a specific condition or problem) are reported with the appropriate new or established patient codes." I have explained that when a pediatrician refers a patient to us for ear infections, we give our opinion on what treatment is needed, perform surgery and then send the patient back to the pediatrician. If the patient has another ear infection, we ask that they see their pediatrician for management of the acute infection. I argue that what we do does not constitute a "transfer of care". They suggested I reach out to KZA for clarification. Thank you!
E/M During Global Period for Diabetic Foot Ulcer Following Total Metatarsal Amputation
If a patient has a total metatarsal amputation for diabetic foot ulcer and he gets readmitted for another condition, but then vascular surgery is consulted for his original underlying condition of DFA and now is treating the ulcer at the amputation site, 80 days post-op is the E/M billable? The TMA surgical wound is healing . The right plantar DFU stage 3 Wagner needs debridement and dressing changes.
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