ATPR.book Page 1 Thursday, N ovem ber 15, 2012 3:09 PM Coding Companion for Plastics/Dermatology A comprehensive illustrated guide to coding and reimbursement 2013 ATPR.book Page i Thursday, N ovem ber 15, 2012 3:09 PM Contents Getting Started with Coding Companion .............................i Arteries/Veins...................................................................365 Skin .....................................................................................1 Lips .................................................................................368 Nails ..................................................................................30 Vestibule of Mouth ..........................................................381 Pilonidal Cyst.....................................................................34 Tongue............................................................................384 Repair ................................................................................35 Palate/Uvula ....................................................................388 Destruction......................................................................131 Abdomen ........................................................................402 Breast ..............................................................................144 Genitalia..........................................................................403 General Musculoskeletal ..................................................167 Extracranial Nerves ..........................................................407 Head................................................................................181 Ocular Adnexa.................................................................428 Neck/Thorax....................................................................296 External Ear .....................................................................453 Shoulder..........................................................................301 Operating Microscope.....................................................457 Humerus/Elbow ...............................................................303 Medicine Services ............................................................458 Forearm/Wrist..................................................................306 Appendix.........................................................................463 Hand/Fingers ...................................................................321 CCI Edits .........................................................................474 Endoscopy.......................................................................354 Evaluation and Management ..........................................477 Nose................................................................................357 Index...............................................................................499 CPT only © 2012 American Medical Association. All Rights Reserved. © 2012 OptumInsight, Inc. Coding Companion for Plastics/Dermatology Contents ICD-9-CM Diagnostic 801.60 Open fracture of base of skull with cerebral laceration and contusion, 21340 801.00 Closed fracture of base of skull 21340 unspecified state of consciousness Percutaneous treatment of nasoethmoid without mention of intracranial injury, complex fracture, with splint, wire or unspecified state of consciousness 801.61 Open fracture of base of skull with headcap fixation, including repair of cerebral laceration and contusion, no 801.01 Closed fracture of base of skull canthal ligaments and/or the nasolacrimal loss of consciousness without mention of intracranial injury, apparatus no loss of consciousness 801.62 Open fracture of base of skull with cerebral laceration and contusion, 801.02 Closed fracture of base of skull brief (less than one hour) loss of without mention of intracranial injury, consciousness brief (less than one hour) loss of consciousness 801.63 Open fracture of base of skull with cerebral laceration and contusion, 801.03 Closed fracture of base of skull moderate (1-24 hours) loss of without mention of intracranial injury, consciousness moderate (1-24 hours) loss of consciousness Terms To Know 801.04 Closed fracture of base of skull without mention of intracranial injury, fracture. Break in bone or cartilage. prolonged (more than 24 hours) loss incision. Act of cutting into tissue or an of consciousness and return to organ. pre-existing conscious level 801.05 Closed fracture of base of skull CCI Version 18.3 without mention of intracranial injury, 0213T, 0216T, 0228T, 0230T, 12001-12007, prolonged (more than 24 hours) loss 12011-12057, 13100-13153, 21280, of consciousness, without return to 21337-21338, 36000, 36400-36410, pre-existing conscious level 36420-36430, 36440, 36600, 36640, 37202, 43752, 51701-51703, 62310-62319, 801.06 Closed fracture of base of skull 64400-64435, 64445-64450, 64479, 64483, without mention of intracranial injury, 64490, 64493, 64505-64530, 69990, loss of consciousness of unspecified 93000-93010, 93040-93042, 93318, 94002, Explanation duration 94200, 94250, 94680-94690, 94770, 801.09 Closed fracture of base of skull 95812-95816, 95819, 95822, 95829, 95955, The physician repairs fractures of the without mention of intracranial injury, 96360, 96365, 96372, 96374-96376, nasoethmoid region with percutaneous 97597-97598, 97602-97606, 99148-99149, unspecified concussion (through the skin) approaches. Percutaneous 99150 801.11 Closed fracture of base of skull with pins or screws are placed into stable bone and Note: These CCI edits are used for Medicare. attached to external support such as splints, cerebral laceration and contusion, no Other payers may reimburse on codes listed headcaps, or wire fixation to aid in reduction loss of consciousness above. of the fractures. If the medial canthal 801.12 Closed fracture of base of skull with ligaments are detached, they are repaired cerebral laceration and contusion, Medicare Edits through a percutaneous approach with awls brief (less than one hour) loss of Fac Non-Fac or K-wires and transnasal stainless steel sutures consciousness RVU RVU FUD Status or wire. Injuries of the nasolacrimal complex 21340 24.27 24.27 90 A are repaired using non-resorbable sutures and 801.13 Closed fracture of base of skull with Head polyethylene tubing. cerebral laceration and contusion, MUE Modifiers moderate (1-24 hours) loss of 21340 1 51 N/A N/A 80* Coding Tips consciousness * with documentation For open treatment of a nasoethmoid fracture, 801.50 Open fracture of base of skull without Medicare References: None with or without external fixation, see 21338 mention of intracranial injury, and 21339. For radiology services, see unspecified state of consciousness 70140–70170. 801.51 Open fracture of base of skull without mention of intracranial injury, no loss ICD-9-CM Procedural of consciousness 21.71 Closed reduction of nasal fracture 801.52 Open fracture of base of skull without 76.78 Other closed reduction of facial mention of intracranial injury, brief fracture (less than one hour) loss of consciousness Anesthesia 801.53 Open fracture of base of skull without 21340 00160 mention of intracranial injury, moderate (1-24 hours) loss of consciousness CPT only © 2012 American Medical Association. All Rights Reserved. © 2012 OptumInsight, Inc. Coding Companion for Plastics/Dermatology Head — 263 are AP axial (front to back), lateral, and PA axial patient must remain still while lying on a motorized 70100-70110 (back to front). X-rays may be taken with the patient table within the large, circular MRI tunnel. A sedative placed erect, prone, or supine and either code may may be administered as well as contrast material for 70100 Radiologic examination, mandible; partial, include stereoradiography, which is a technique image enhancement. This code reports an exam of less than 4 views that produces three-dimensional images. the temporomandibular joint(s). 70110 complete, minimum of 4 views Appendix Explanation 70300-70320 70350 70300 Radiologic examination, teeth; single view 70350 Cephalogram, orthodontic The lower jaw bone is x-rayed. In 70100, three or 70310 partial examination, less than full less projections are taken for a partial view of the mouth Explanation bone structure and in 70110, four or more 70320 projections are taken for a complete view of the complete, full mouth A lateral or frontal x-ray projection is taken to bone structure. examine the entire skull, jaw, and related tooth Explanation positions. The machine holds the patient's head in Films are taken of the mouth to show teeth and/or the same position each time so that a series of 70140 cephalograms can be directly compared for growth 70140 Radiologic examination, facial bones; less surrounding bone. In dental radiography, the film may be placed either inside or outside the mouth. and development over time. than 3 views Code 70300 reports a single view only, 73010 Explanation reports a partial examination, and 70320 reports a 70355 complete full mouth exam. 70355 Orthopantogram (eg, panoramic x-ray) X-rays of the facial bones are obtained to determine an injury, fracture, or neoplasm. After positioning 70328-70330 Explanation the patient, less than three views of the facial bones 70328 Radiologic examination, A panoramic radiographic study is performed on are obtained. The physician supervises the the mandibular arch and its supporting structures. procedure and interprets and reports the findings. temporomandibular joint, open and closed mouth; unilateral A single