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General Surgery Coding Alert

Updates to Breast Biopsy and Arthrodesis Codes Top CPT 2001 Changes
The 2001 CPT manual, which becomes effective Jan. 1, 2001, includes several new codes and ... Read more
Use Modifier -60 to Correctly Bill Complex Adhesion Removal
CPT 2001s new modifier, -60 (altered surgical field), could be good news for general surg... Read more
Latest CCI Bundles E/M to Codes With No Global Period
Effective Oct. 30, 2000, evaluation and management (E/M) services performed at the same ti... Read more
Reader Question:
Removing a Healthy Breast
Question: A patient has cancer in one breast and needs a modified radical mastectomy. Beca... Read more
Reader Question:
Presurgical H&P
Question: Can we charge for a preoperative visit when a history and physical (H&P) for sur... Read more
Reader Question:
Gunshot Wound
Question: A patient has a gunshot wound to the abdomen. How should I code excision and clo... Read more
You Be the Coder:
AngioJet for Thrombectomy of AV Fistula
Question: What CPT code should be used when performing mechanical thrombectomy with the Po... Read more
Understanding HCFAs Special Coding Status Is Key to Billing Colonoscopies Correctly
Colonoscopy billing presents a challenge for general surgeons and their coders because p... Read more
Sparse Use of Prolonged Service Codes Is Profitable
Prolonged services are a good way for general surgeons to get reimbursed for significant e... Read more
Reader Question:
E/M and Lesion Removal
Question: Patients frequently are referred to our office for evaluation of skin lesions. O... Read more
Reader Question:
Using the -GA Modifier
Question: Can you explain how to correctly use the -GA modifier?Texas Subscriber Answer: ... Read more
Reader Question:
Insertion of PICC
Question: Can we get reimbursed for inserting PICC lines in an acute-care setting? Is ther... Read more
You Be the Coder:
Incision vs. Excision of Hemorrhoids
Question: Please explain the difference between codes 46083 and 46320. The definitions of ... Read more
Waiting for Colostomy Closure Pathology Results Can Optimize Payment
When a physician closes a colostomy, resection and anastomosis of the bowel may or may not... Read more
Bill Nissen Separately From Other Anti-reflux Procedures
Nissen fundoplication is one method general surgeons use to treat gastroesophageal reflux ... Read more
Use Musculoskeletal Codes For Deep Abscess I&D
"When billing for abscess procedures, coders need to look beyond the integumentary ... Read more
Reader Question:
Assistant Surgeon
Question: How do I code when one surgeon assisted another and modifier -80 (assistant surg... Read more
Reader Question:
99211 With Injection
Question: I am told that we cannot bill for an evaluation and management (E/M) on a patien... Read more
You Be the Coder:
Prevent Breast Excision Confusion
Test your coding knowledge. Determine how you would code this situation before looking at... Read more
Billing for E/M on the Same Day as Procedure is Not Affected by Number of Diagnoses
Some general surgeons and coders are uncertain about whether and when to bill a visit on t... Read more
Case Study:
Ileoscopy Payable by Using Small Bowel Endoscopy Code
"General surgeons typically do not perform many endoscopic explorations of the small intes... Read more
Avoid Billing Errors When Surgeons Need Substitutes
Surgeons temporarily unable to care for their patients have two billing options: Enter ... Read more
Clarifications
The July article in General Surgery Coding Alert, Gain Reimbursement for the Revision of A... Read more
Reader Question:
Coding a Lesion as Benign Or Malignant
Question: How do you code a lesion of the skin if, at the time of excision, the surgeon do... Read more
Reader Question:
Appropriate Use of Modifier -62
Question: We are under the impression that modifier -62 (two surgeons) should be used by s... Read more
You Be the Coder:
Bypass Graft Coding
Test your coding knowledge. Determine how you would code this situation before looking at... Read more
Get Paid for Laparoscopy Turned Open Using the Correct Modifier
Sometimes general surgeons begin a procedure laparoscopically, but decide to convert to an... Read more
Get a Request for Consults to Properly Gain Reimbursement
General surgeons called in to the operating room (OR) to render an opinion should bill int... Read more
Case Study:
Documentation is Key to Getting Paid for Excision of Lesions
When surgeons remove multiple benign lesions from a patient, each excision should be bille... Read more
Reader Question:
Intravascular Ultrasound
Question: In addition to billing 33533 (coronary artery bypass, using arterial graft[s]; s... Read more
Reader Question:
Hemorrhoidectomy
Question: The surgeon performed two internal and external hemorrhoidectomies. Which CPT co... Read more
Reader Question:
Removal of Marlex Dual Mesh
Question: What code would you use for the removal of an infected Marlex Dual Mesh by lapar... Read more
You Be the Coder:
Bundling Marcaine
Question: Which J-codes should be used for coding an injection of Marcaine? Is there a dif... Read more
Gain Reimbursement for the Revision of AV Fistulas and Subsequent Thrombectomies
Nugget: Optimize payment for fistula complications by correctly identifying the type of ... Read more
Surgeon-Coder Communication Critical for ED Services Payment
Nugget: Two main factors determine how emergency department services are paid when the su... Read more
Reader Questions:
Implant Removal
Implant Removal Question: Our surgeon removed four screws and one plate from the fibula as... Read more
Reader Questions:
Surgery Consults
Question: When I am consulted in the hospital about a patient and I recommend surgery the ... Read more
Get Paid for Add-on Liver Biopsies With Separate Diagnosis Code
Many general surgeons have problems getting paid for percutaneous liver biopsies performed... Read more
Signs/Symptoms Codes Increase Pay Up and Safeguard Patients
ICD-9 signs and symptoms codes should be used to provide medical necessity for a procedure... Read more
Clarification:
Breast Lump Diagnosis
"In the You Be the Coder answer on page 45 of the May general surgery coding Alert, a sur... Read more
Correction
In the article Medical Necessity Required to Correctly Bill Appendectomy Add-on Code on pa... Read more
Reader Question:
Outside Lab Tests
Question: I performed a fine needle aspiration biopsy on a breast mass (88170). Medicare d... Read more
Reader Question:
Code Anastomosis Separately From Bowel Resection
Question: A patient previously has undergone a right hemicolectomy. Now the patient has a ... Read more
Reader Question:
Appeal Modifier -57 Denials
Question: Recently, Ive noticed more and more insurance carriers either denying or bundlin... Read more
You Be the Coder:
Initial and Recurrent Hernias
Test your coding knowledge. Determine how you would code this situation before looking at... Read more
Obtain Proper Reimbursement for Breast Biopsies
Nugget: If the operative report isn't clear, coders should ask their physicians what proc... Read more
Pathology Report Critical to Lesion Excision Coding
Nugget: If a surgeon excises more tissue to remove margins and the lesion turns o... Read more
Case Study:
Documenting Separate Incisions Can Get Two Procedures Paid
Nugget: Coders can find critical information by carefully reading the body of the surgeon... Read more
Look for Corrections to CCI Version 6.1 Errors
Nugget: The errors in the initial release of CCI version 6.1 involved the incorrect assign... Read more
Reader Question:
Second Procedures Billed With Modifier -59
Question: On occasion, a patient needs both an upper and lower endoscopy (EGD and colonosc... Read more
Reader Question:
National Physician Fee Schedule
Question: Can you tell me how to find out global periods for each of the general surgery C... Read more
You Be the Coder:
Diagnosing Breast Lumps
Test your coding knowledge.  Determine how you would code this situation before look... Read more
Medical Necessity Required to Correctly Bill Appendectomy Add-on Code
General surgeons may face difficulties getting reimbursed when they perform an appendectom... Read more
Increase Pay Up by Properly Using Critical Care Codes
CPT and Medicare have clarified and somewhat eased the stringent guidelines for critical c... Read more
Findings Section in Your Op Report Can Make Billing Easier
General surgeons should include a short section in their op notes that explains what they ... Read more
Reader Question:
Hernia Repair
Question: A patient has repair of recurrent right inguinal hernia and initial left inguina... Read more
Reader Question:
Ventilation Management
Question: Is there a way to code for vent management in cases such as 1. ARDS immediately ... Read more
You Be the Coder:
Lesion Removal
Test your coding knowledge. Determine how you would code this situation before looking at... Read more
Special Report:
Coding E/M Levels Using Correct Documentation Is Surgeons Biggest Source of Untapped Revenue
For a variety of reasons, many general surgeons pay scant attention to the documentation s... Read more
Case Study:
Clearly Written Op Note Allows Billing for More Procedures
"When a general surgery coder reads the top of a surgeons operative note that lists... Read more
How to Avoid Confusing Modifiers -52 and -53
Some general surgery coders have problems distinguishing between modifiers -52 (reduced s... Read more
Reader Question:
IVC Filter
Question: I have been having problems billing for inferior vena cava (IVC) filter placemen... Read more
Reader Question:
Bill Co-surgery Correctly With Modifier -62
Question: The operation was clipping of an ICA aneurysm in the circle of Willis by a neur... Read more
Reader Question:
Billing for Intraoperative Consult
Question: I work for a general surgeon in a solo practice. On occasion, he is called to th... Read more
Reader Question:
No Fee Schedule Yet for Sentinel Node Code
Question: In the December 1999 General Surgery Coding Alert on page 41, code 38792 for ide... Read more
You Be the Coder:
Hernia Repair
Test your coding knowledge. Determine how you would code this situation before looking at... Read more
Get Paid for Extra Effort by Billing Complications
When complications occur during surgery, they often take extra time for the general surgeo... Read more
Correct Coding Initiative 101:
Understanding Medicares CCI Is Powerful Compliance Tool
Unbundlingcoding for two or more procedures that should not be billed togetheris a major c... Read more
Case Study:
Use Modifiers to Bypass Endarterectomy, Graft Bundling
If surgeons fail to code endarterectomies and grafts performed on different limbs during... Read more
Yo Be the Coder:
Converting Laparoscopic to Open Cholecystectomy
Test your coding knowledge. Determine how you would code this situation before looking at... Read more
Reader Question:
Unna Boots and Office Visits
Question: Our physicians are surgeons, and from time to time they perform minor surgical p... Read more
Reader Question:
Laparoscopic Lysis of Adhesions
Question: A general surgeon was performing a gallbladder removal through the scope and c... Read more
Reader Question:
Charging for X-ray, MRI Interpretations
Question: Can general surgeons charge for reading x-rays and MRIs taken at an outside faci... Read more
New Codes Expand Billing for Laceration Repairs
" CPT 2000 introduced several add-on codes for the repair of lacerations. These codes may ... Read more
Minimize Denials for Vein Stripping Claims
Vein ligation and stripping procedures often are rejected by payers, including Medicare, a... Read more
Documentation and Modifiers Key When Billing Transfer of Care
Because most surgeries have a built-in global period that includes postoperative procedure... Read more
Corrections
In the November issue of General Surgery Coding Alert on p. 39, we incorrectly stated that... Read more
Reader Question:
Necrotizing Fasciitis
Question: What is the CPT code for radical debridement of the lower abdominal wall, includ... Read more
Reader Question:
No Resection, No Payment
Question: A patient is seen with acute bowel obstruction. He has a strangulated hernia, wh... Read more
You Be the Coder:
Laparoscopic Intestinal Lesion Excision
Test your coding knowledge. Determine how you would code this situation before looking at... Read more
Available Years:  2000  1999