For many years I struggled coding foot and ankle procedures.
I would ask myself:
“Is this tendon a flexor or is it an extensor?”
“Hmm... what does it do?”
“Is this a ligament or is this a tendon?”
Of course, back then we didn’t have internet and had to utilize other resources. This usually meant going to the physician and asking because we didn’t have the abundance of resources like we do today. Thank goodness for technology!
Foot and ankle cases can be quite complex at times and usually, several resources are needed to help determine whether the CPT codes are bundled. When coding foot and ankle procedures, I find it necessary to use my Encoder, the National Correct Coding Initiative (NCCI), and the AAOS Global Data guide (American Academy of Orthopedic Surgeons). All three play a key role in putting the pieces of the puzzle together. It also helps to have some good-quality pictures to refer to.
What do you do when the AAOS indicates a specific procedure code is included in the primary procedure performed, but the NCCI edits does not bundle them?
It’s critical to understand the procedure and be able to sort out which set of rules your practice is going to follow on a regular basis. As you already know, it would not be appropriate to use one set of rules for one patient and then a different set for the next.
Remember, you should always be consistent in your reporting!
Mary Bort, CPC, CPMA, CANPC, CASCC, COSC
Consultant
During her free time, she loves to do crafts, enjoys the outdoors, and the Broncos! She has 4 daughters, and 10 grandchildren which light up her life.