2017 Advanced Specialty Coding Symposium: Make sure to follow payer requirements prior to billing FAI repair

Why This Topic Matters

The article helps readers recognize where payer policies and documentation expectations can affect reimbursement and claim acceptance across several orthopedic services. It is especially relevant for practices seeking to align operative notes and reporting practices with payer review requirements.

Article Sections

1. FAI repair payer requirements and documentation support

   Discusses general payer expectations for femoroacetabular impingement surgery and the types of documentation emphasized at the symposium. It also addresses the broader role of imaging, conservative treatment history, and operative-note support.

2. Operative note language for FAI surgery

   Presents a suggested documentation approach for physicians to support an FAI surgery claim. The section focuses on how operative notes may be structured to reflect the clinical history and imaging support discussed earlier.

3. Separate procedure documentation and reporting

   Covers how coding notes should distinguish separate procedures within the same session. It uses orthopedic examples to illustrate the documentation concept discussed at the symposium.

4. Rotator cuff repair coding considerations

   Reviews documentation distinctions discussed for open rotator cuff repair and related coding selection considerations. The section also notes the role of physician documentation in distinguishing procedure types.

5. Amniotic injection reporting

   Addresses reporting considerations for an unlisted or bundled amniotic injection scenario. The discussion references broader guidance on processed graft-related services.

6. Ulnar styloid fracture treatment with distal radial fracture care

   Explains reporting considerations when ulnar styloid fracture treatment occurs alongside distal radial fracture treatment. It distinguishes among the treatment approaches discussed in the article.

7. Intraoperative imaging and official interpretation

   Summarizes guidance on when intraoperative imaging may be separately reported and the documentation elements emphasized by professional organizations. It also references where billing responsibility may differ by setting.

8. Spinal cage and plate implant reporting

   Discusses implant billing considerations when spinal cages and plates are connected during placement. The section also highlights documentation of device details in the operative note.