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Appropriate CPT Coding for OLLIF
I have a provider who wants to code 22558 for a procedure that is done posterior only. I am coding as TLIF, posterior interbody fusion with posterolateral fusion and Laminectomy, facetectomy, foraminotomy for decompression with discectomy. He states this is OLLIF not OLIF but still wants 22558. There is no repositioning of the patient. He does not enter the retroperitoneal space. All incisions are done posteriorly. Any guidance?
Bundling of Drug-Induced Sleep Endoscopy and Turbinate Procedures
Can you explain why the sleep endoscopy 42975 and any turbinate procedure is bundled? The procedures are done for two completely different reasons—OSA and turbinate hypertrophy.
Reporting 36015
We have seen some illustrations suggesting the maximum number for reporting 36015 in one session is 5 (3-right(U,M,L), 2 Left(U,L). This method only counts the lobar arteries and excludes counting the segmental arteries. Is it your opinion that each segmental artery can be individually reported? For example, if the provider performed selective catheterization on the right side of the medial basal segment, the posterior basal segment and the lateral basal segment would this count as three (3) total under the lower lobe or count as one (1) since all are in the lower lobe?
Benign Lesion Destruction
My provider destroyed 5 lesions on the penis, and then 5 lesions on the scrotum and groin area. Can I code 54056 and 17110?
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?
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