• E-mail
• Print
• RSS

Topic: Be a G whiz: Understand when to assign G codes, new codes (part two)

Ambulatory Surgery Reimbursement Update, November 11, 2008

Reimbursement does come into play for code G0260 (injection procedure for sacroiliac joint; provision of anesthetic, steroid and/or other therapeutic agent, with or without arthrography). Many coders may not realize that when coding sacroiliac joint injections, they should assign code G0260 for Medicare patients, says Susan Kiser, CPC, an independent coding consultant based in Broken Arrow, OK.

She adds that some coders may be more familiar with and therefore assign code 27096 for the injection procedure, which is only appropriate for the physician office or ASC setting for commercial payers.

The 2008 CPT Manual also included a new code for an arthroscopic biceps tenodesis (code 29828). Although code 29828 is a long-awaited addition, many coders are having trouble recognizing when it is appropriate to assign this code.

When performing a biceps tenodesis, many physicians perform a shoulder surgery through the arthroscope and then open one of the portals 1 cm–1.5 cm to perform the procedure.

Once the physician opens that portal, the procedure is now an open procedure, and coders should assign code 23430 (tenodesis of the long tendon of bicep) instead of code 29828, Kiser says.

This is yet another example of when coders could get into trouble by reading only the heading of an operative report. The operative report heading might only state arthroscopic biceps tenodesis and not mention the technique the physician used in the procedure. Coders need to read the complete operative report to confirm which technique and code they should report, says Kiser.

It’s also important to note that coders should not bill code 29828 with a diagnostic shoulder arthroscopy, arthroscopic shoulder synovectomy, or an arthroscopic shoulder debridement procedure, according to the 2008 CPT Manual.

Editor’s note: This topic is from the November 2008 issue of Ambulatory Surgery Coding and Reimbursement Insider.

• E-mail to a Colleague
• Print
• RSS
• Archive