Cts Denials: Do Away With These Myths

By Author: Celena Rose
Total Articles: 146
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If a patient's Carpal Tunnel Syndrome (CTS) treatment stretches into extended care, do you let carrier's strict guidelines stop your rightful reimbursement?

It's a strict no no. Instead train your providers to document medical necessity by carefully outlining the condition's progressive nature. Here are a few myths which you need to keep at bay in order to safeguard yourself against CTS denials.

There's only one type of treatment

Reality: Physicians do use a range of treatments for CTS patients. Sometimes the non-invasive treatments can become invasive when the non-invasive treatments are non-responsive. Depending on the severity of the condition, initial treatment may be conservative.

Injections? A bilateral modifier is not called for

Reality: If your orthopaedic surgeon injects both of the patient's wrists during CTS treatment, you'll need to report it as a bilateral procedure. For this you can report modifier 50 or modifiers LT (left side) and (right side).

Surgeries do not require pre-authorization
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Reality: As surgery is the last-resort treatment for CTS, many coders recommend that you obtain pre-authorization to determine your carrier's limitations.

It's easy to use ICD-9 codes

Reality: If you thought ICD-9 codes would make easy coding just because it includes only one CTS diagnosis: 354.0, think again. Carrier policies complicate your situation. A stand-alone diagnosis of CTS doesn't justify all forms of treatment in some carriers' eyes.

An experienced and certified coder is less likely to be bowled over such myths.
For one, you can sit for AAPCs Certified Orthopaedic Surgery Coder (COSC) exam and obtain a COSC certification that'll not only give more bones to your coding but also take your orthopaedic coding career places.

You can sign up for a COSC training camp to make your task of passing the exam easier.



codingcert.com provides selected trainers that gives you hands-on training for becoming a coding professional and a medical coder through medical coding certification at our CPC training camp.