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Episodes of Care Offerings

Holista Health

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  Orthopedic Procedures
Procedure Bundle - Orthopedic with Physical Therapy Primary Billing Code
Anterior Cervical Fusion 22551
Anterior Cervical Fusion multiple level 22551 & 22552
Anterior Lumbar Fusion 22612
Repair of Ruptured Muscultotendinous Cuff 23412
Total Shoulder, Arthroscopy 23472
Tendon Shealth Incision (trigger finger release) 26055
Hip, Total Replacement 27130
Revision of Knee Joint (partial knee) 27446
Knee, Total Replacement 27447
Open Treatment of Distal Fibular Fracture 27792
Open Treatment of Distal Tibiofibular Joint (syndesmosis) disruption, internal fixation 27829
Correction Hallux Valgus with or without sesamoidectomy 28299
Open Treatment of Metatarsal Fracture 28485
Shoulder, Arthroscopy - surgical; capsulorrhapy 29806
Shoulder, Arthroscopy - surgical; repair of SLAP lesion 29807
Shoulder, Arthroscopy - debridement 29822
Shoulder, Arthroscopy - debridement, extensive 29823
Shoulder, Arthroscopy 29824
Shoulder, Arthroscopy - surgical; subacromial decompression 29826 & 29822
Shoulder, Arthroscopy - debridement extensive, subacromial decompression 29826 & 29823
Shoulder, Rotator Cuff (arthroscopic) 29827
Shoulder, Arthroscopy - bicep tenodesis 29828
Knee, Arthroscopy 29877
Knee, Arthroscopy - surgical; abrasion arthroplasty 29879
Arhroscopic Meniscectomy medial and lateral 29880
Arhroscopic Meniscectomy medial OR lateral 29881
Knee, Arthroscopy - Meniscal Repair (medial or laterall) 29882
Knee ACL/MCL Repair 29888
Hip, Arthroscopy (Fermoroplasty) 29914
Hip, Arthroscopy (Acetabluloplsty) 29915
Hip, Arthroscopy (Labral Repair) 29916
Laminotomy, Lumbar 63030
Spinal Disk Surgery add-on 63035
Laminotomy Singel Lumbar 63042
Remove Spine Lamina 1 Lumbar 63047
Decompress Spinal Cord Lumbar 63056
Neuroplasty, Elbow 64718

 

Procedure Bundle - Orthopedic without Physical Therapy Primary Billing Code
Excision of Lesion of Tendon Sheath or Joint Capsule 26160
Patellofemoral 27438
Correction, Hammertoe 28285
Hallux Rigidus Correction with Cheilectomy 28289
Correction Hallus Valgus 28292 or 28296
Arthroscopy, Wrist, Surgical: excision and/or repair 29846
Carpal Tunnel (ASC) 64721
Carpal Tunnel (In Office) 64999 / 76946
Carpal Tunnel - Bilateral (In Office) 64999 / 76946 -50

 

  Ear Nose & Throat Procedures
Procedure Bundle Primary Billing Code
Bilateral Myringotomy and tubes 69436-50
Adentonsillectomy <12 y/o 42820
Adentonsillectomy >12 y/o 42821
Tonsillectomy <12 y/o 42825
Tonsillectomy >12 y/o 42826
Adeniodectomy <12 y/o 42830
Adeniodectomy >12 y/o 42831
Septoplasty 30520
Bilateral Turbinate Reduction 30140-50
Septoplasty and Turbinate Reduction 30520, 30140-50
Closed Reduction of nasal fracture with stabilization 21320
  Obstetrics
Procedure Bundle Primary Billing Code
Maternity (Mom & Baby) C-section: MS DRG 765-767, Vaginal Delivery: MS DRG 774-775, Newborn: MS DRG 789, 791-795
  Gastrointestinal Procedure
Procedure Bundle Primary Billing Code
Colonoscopy 45378, 45380, 45381, 45384, 45385
  Office Based Procedures
Procedure Bundle Primary Billing Code
Carpal tunnel release 64721
Bilateral carpal tunnel release 64721 - 50
Bilateral carpal tunnel release with additional services 64721 - 50, 22
Reconstruction of tendon pulley, each tendon(Dequervain's 1st compartment release) 25000
Reconstruction of tendon pulley with additional services 25000 - 22
Bilateral reconstruction of tendon pulley 25000 - 50
Bilateral reconstruction of tendon pulley with additional services 25000 - 50, 22
Excision of lesion on tendon sheath or joint capsule (eg, cyst, mucous cyst, or ganglion), hand or finger 26160
Excision of lesion on tendon sheath or joint capsule with addtional services 26160 - 22
Bilateral excision of lesion on tendon sheath or joint capsule  26160 - 50
Bilateral excision of lesion on tendon sheath or joint capsule with additional services 26160 - 50, 22
Repair, extensor tendon, hand, primary or secondary; without free graft, each tendon 26410
Repair, extensor tendon, hand, primary or secondary with additional services 26410 - 22
Bilateral repair, extensor tendon, hand, primary or secondary; without free graft, each tendon 26410 - 50
Bilateral repair, extensor tendon, hand, primary or secondary with additional services 26410 - 50, 22
Fasciotomy, palmar (eg, Dupuytren's contracture); percutaneous 26040
Fasciotomy, palmar (eg, Dupuytren's contracture); percutaneous with additional services 26040 - 22
Bilateral fasciotomy, palmar (eg, Dupuytren's contracture); percutaneous 26040 - 50
Bilateral fasciotomy, palmar (eg, Dupuytren's contracture); percutaneous with additional services 26040 - 50, 22
Tendon sheath incision (eg, for trigger finger) with additional services 26055 - 22
Bilateral tendon sheath incision (eg, for trigger finger) 26055 - 50
Bilateral tendon sheath incision (eg, for trigger finger) with additional services 26055 - 50, 22
  Sleep Study Episodes
Procedure Bundle Primary Billing Code
Home Sleep Study: CPAP 95806 / E0601
Baseline in-lab Sleep Study: BIPAP 95810, 95811 / E0470
Titration in-lab Sleep Study: BIPAP/ASV/ST/AVAPS 95811 / E0471
PSG/MSLT - Bundle 95810, 95811 / 95805
Baseline in-lab Sleep Study: CPAP 95810, 95811 / E0601

 

  General Surgery Episodes
Procedure Bundle Primary Billing Code
Hemorrhoidectomy, internal and external, 2 or more columns/groups 46260
Laparoscopy, surgical; cholecystectomy with cholangiography 47563
Repair initial inguinal hernia, age 5 or older; reducible 49505
Repair umbilical hernia, age 5 or older; reducible 49585
Repair initial incisional or ventral hernia 49650
Bilateral repair initial incisional or ventral hernia 49650 - 50

 

  Conservative Musculoskeletal Episodes
Procedure Bundle Primary Billing Code Diagnosis Code
Carpel Tunnel Treatment 97161 G56.01
Knee Pathology Treatment 97161 M23.91
Shoulder Pathology Treatment 97161 M24.811
Hip Pathology Treatment 97161 M25.551
Lower Back Pain - Acute 97161 M54.50
Lower Back Pain - Subacute 97161 G89.29
Lower Back Pain - Chronic 97161 G89.4

 

  MRI Episodes
Procedure Bundle Primary Billing Code
MRI, Lumbar, without contrast 72148
MRI, Any joint of upper extremity, without contrast 73221
MRI, Lower extremity other than joint, without contrast 73718
MRI, Any joint of lower extremity, without contrast 73721
MRI, Any joint of lower extremity, with contrast 73722