CTS denials: Do away with these myths

If a patient’s Carpal Tunnel Syndrome (CTS)(left side) and (right side).
treatment stretches into extended care, do you letSurgeries do not require pre-authorization
carrier’s strict guidelines stop your rightfulReality: As surgery is the last-resort treatment for
reimbursement?CTS, many coders recommend that you obtain
It’s a strict no no. Instead train your providers topre-authorization to determine your carrier’s
document medical necessity by carefully outlining thelimitations.
condition’s progressive nature. Here are a fewIt’s easy to use ICD-9 codes
myths which you need to keep at bay in order toReality: If you thought ICD-9 codes would make
safeguard yourself against CTS denials.easy coding just because it includes only one CTS
There’s only one type of treatmentdiagnosis: 354.0, think again. Carrier policies complicate
Reality: Physicians do use a range of treatments foryour situation. A stand-alone diagnosis of CTS
CTS patients. Sometimes the non-invasivedoesn’t justify all forms of treatment in some
treatments can become invasive when thecarriers’ eyes.
non-invasive treatments are non-responsive.An experienced and certified coder is less likely to be
Depending on the severity of the condition, initialbowled over such myths. For one, you can sit for
treatment may be conservative.AAPC”s Certified Orthopaedic Surgery Coder
Injections? A bilateral modifier is not called for(COSC) exam and obtain a COSC certification
Reality: If your orthopaedic surgeon injects both ofthat’ll not only give more bones to your coding
the patient’s wrists during CTS treatment,but also take your orthopaedic coding career places.
you’ll need to report it as a bilateral procedure.You can sign up for a COSC training camp to make
For this you can report modifier 50 or modifiers LTyour task of passing the exam easier.