General Surgery Coding Alert
Differentiate Thoracic Procedures To Ensure Proper Payment
Coding for thoracic procedures involving thoracotomy, which requires o... Read more
Coding for thoracic procedures involving thoracotomy, which requires o... Read more
Office Protocols Ensure Proper Billing Procedures
Surgery practices require protocols that guide the entire coding, billing and reimbursem... Read more
Surgery practices require protocols that guide the entire coding, billing and reimbursem... Read more
Correction:
Mammograms
General Surgery Coding Alert, October 2001, page 77, notes that three new ICD-9 mammogram ... Read more
Mammograms
General Surgery Coding Alert, October 2001, page 77, notes that three new ICD-9 mammogram ... Read more
Reader Question:
Placement of Metallic Localization Clip
Question: When is it appropriate to report 19295?Tennessee Subscriber Answer: ... Read more
Placement of Metallic Localization Clip
Question: When is it appropriate to report 19295?Tennessee Subscriber Answer: ... Read more
Reader Question:
Insertion of J-P Drain
Question: The patient had partial mastectomy with axillary lymph node dissection. Six... Read more
Insertion of J-P Drain
Question: The patient had partial mastectomy with axillary lymph node dissection. Six... Read more
Reader Question:
Atypical Hyperplasia of Breast
Question: I have been using ICD-9 code 611.1 for atypical hyperplasia of the breast, but I... Read more
Atypical Hyperplasia of Breast
Question: I have been using ICD-9 code 611.1 for atypical hyperplasia of the breast, but I... Read more
Reader Question:
Complications During a Procedure
Question: During lysis of adhesions, the patients bowel was inadvertently nicked. Should w... Read more
Complications During a Procedure
Question: During lysis of adhesions, the patients bowel was inadvertently nicked. Should w... Read more
Reader Question:
Excision of Single Varicose Vein
Question: The surgeon notes a 5-mm well-circumscribed blue firm mass palpable within the v... Read more
Excision of Single Varicose Vein
Question: The surgeon notes a 5-mm well-circumscribed blue firm mass palpable within the v... Read more
Reader Question:
Tourniquet Time and Modifier -22
Question: We did a below-knee amputation on a patient. The operative report states that th... Read more
Tourniquet Time and Modifier -22
Question: We did a below-knee amputation on a patient. The operative report states that th... Read more
Reader Question:
Axillary Lump Diagnosis
Question: I cannot find a diagnosis code that accurately reports an axillary lump. Should ... Read more
Axillary Lump Diagnosis
Question: I cannot find a diagnosis code that accurately reports an axillary lump. Should ... Read more
You Be the Coder:
Modified Radical Mastectomy
Test your coding knowledge. Determine how you would code this situation before look... Read more
Modified Radical Mastectomy
Test your coding knowledge. Determine how you would code this situation before look... Read more
New Fine Needle Aspiration, Laparoscopic Codes Top List of 2002 CPT Changes
An advance look at the 2002 CPT manual reveals several changes that should help genera... Read more
An advance look at the 2002 CPT manual reveals several changes that should help genera... Read more
Medicare Carriers Instructed To Accept Post-Test Diagnoses
Medicare carriers have long differed on whether physicians who perform diagnostic tests ... Read more
Medicare carriers have long differed on whether physicians who perform diagnostic tests ... Read more
Physician Can Admit From Office
Question: When we see a patient in the office who is immediately sent to a hospital for ad... Read more
Question: When we see a patient in the office who is immediately sent to a hospital for ad... Read more
Reader Question:
Normal Evaluation Included in Wound Closure
Question: Can I bill separately for E/M services and wound closure if the E/M service is l... Read more
Normal Evaluation Included in Wound Closure
Question: Can I bill separately for E/M services and wound closure if the E/M service is l... Read more
Reader Question:
Use I and D Code for Stump Infection Debridement
Question: A patient had bilateral above-the-knee amputations. Two weeks later, he was retu... Read more
Use I and D Code for Stump Infection Debridement
Question: A patient had bilateral above-the-knee amputations. Two weeks later, he was retu... Read more
You Be the Coder:
Number of Incisions Determines Biopsy Billing
Test your coding knowledge. Determine how you would code this situation before look... Read more
Number of Incisions Determines Biopsy Billing
Test your coding knowledge. Determine how you would code this situation before look... Read more
Clinical Knowledge Aids Selection of Partial Colectomy Codes
Reporting partial colectomies can be difficult due to the clinical nature of the procedu... Read more
Reporting partial colectomies can be difficult due to the clinical nature of the procedu... Read more
Code Number of Trigger-Point Injections by Muscle Groups
When surgeons provide trigger-point injections, they may perform more than one injection i... Read more
When surgeons provide trigger-point injections, they may perform more than one injection i... Read more
News Brief:
New ICD-9s Effective Oct. 1
In its annual update of ICD-9 codes, CMS announced the introduction of three new diagnosi... Read more
New ICD-9s Effective Oct. 1
In its annual update of ICD-9 codes, CMS announced the introduction of three new diagnosi... Read more
Reader Question:
Bilateral Ligation of Temporal Artery
Question: My surgeon frequently performs bilateral ligations or biopsies of the temporal a... Read more
Bilateral Ligation of Temporal Artery
Question: My surgeon frequently performs bilateral ligations or biopsies of the temporal a... Read more
Reader Question:
Botox and Anal Fissures
Question: Which CPT code should be used to report Botox injections for anal fissures? Are ... Read more
Botox and Anal Fissures
Question: Which CPT code should be used to report Botox injections for anal fissures? Are ... Read more
Reader Question:
Carotid Artery Plication
Question: My doctor performed a carotid endarterectomy followed by a plication because the... Read more
Carotid Artery Plication
Question: My doctor performed a carotid endarterectomy followed by a plication because the... Read more
You Be the Coder:
Standby Services
Test your coding knowledge. Determine how you would code this situation before loo... Read more
Standby Services
Test your coding knowledge. Determine how you would code this situation before loo... Read more
Breast Procedure FAQ:
Solutions for Common Coding Dilemmas
Although breast procedures are common, they still present coding challenges.... Read more
Solutions for Common Coding Dilemmas
Although breast procedures are common, they still present coding challenges.... Read more
Meet the Challenge of Thyroidectomy Coding
Thyroidectomies and other related excisions, such as parathyroidectomies, can pose difficu... Read more
Thyroidectomies and other related excisions, such as parathyroidectomies, can pose difficu... Read more
Reader Question:
Mesh Implantation
Question: How should I code laparoscopic repair of a ventral hernia (initial or recurrent)... Read more
Mesh Implantation
Question: How should I code laparoscopic repair of a ventral hernia (initial or recurrent)... Read more
Reader Question:
Prolonged Services
Question: The surgeon sees a new patient with carotid stenosis in the office for a consult... Read more
Prolonged Services
Question: The surgeon sees a new patient with carotid stenosis in the office for a consult... Read more
Reader Question:
Billing for Resident Services at Teaching Hospital
Question: Does an attending physician have to be in the hospital to bill for any service p... Read more
Billing for Resident Services at Teaching Hospital
Question: Does an attending physician have to be in the hospital to bill for any service p... Read more
You Be the Coder:
Follow-Up Colonic Polypectomy
Test your coding knowledge. Determine how you would code this situation before loo... Read more
Follow-Up Colonic Polypectomy
Test your coding knowledge. Determine how you would code this situation before loo... Read more
CCI 7.2 Adds Hundreds of Surgery Edits
Version 7.2 of the national Correct Coding Initiative (CCI), effective July 1, includes ... Read more
Version 7.2 of the national Correct Coding Initiative (CCI), effective July 1, includes ... Read more
Surgeons Urged To Subscribe to CCI
The sheer number of national Correct Coding Initiative edits that affect general surgeons ... Read more
The sheer number of national Correct Coding Initiative edits that affect general surgeons ... Read more
Trach Tips:
Coding Strategies To Optimize Reimbursement
Reviewed on May 20, 2015 General surgeons usually perform a tracheo... Read more
Coding Strategies To Optimize Reimbursement
Reviewed on May 20, 2015 General surgeons usually perform a tracheo... Read more
Reader Question:
Stent To Support AAA Endograft not Payable
Question: Your February 2001 article about new codes for AAA repairs did not discuss the i... Read more
Stent To Support AAA Endograft not Payable
Question: Your February 2001 article about new codes for AAA repairs did not discuss the i... Read more
Reader Question:
Laparoscopic Repair of Diaphragmatic Hernia
Question: How can I code laparoscopic repair of a diaphragmatic hernia?New Hampshire Subsc... Read more
Laparoscopic Repair of Diaphragmatic Hernia
Question: How can I code laparoscopic repair of a diaphragmatic hernia?New Hampshire Subsc... Read more
Reader Question:
Medicare, Private Carriers Differ on Modifier -50
Question: When using modifier -50 for a bilateral procedure, should we list the procedure... Read more
Medicare, Private Carriers Differ on Modifier -50
Question: When using modifier -50 for a bilateral procedure, should we list the procedure... Read more
Reader Question:
Modifier -78 Requires Return to OR
Question: Please clarify whether modifier -78 can be used only in a hospital. We sometime... Read more
Modifier -78 Requires Return to OR
Question: Please clarify whether modifier -78 can be used only in a hospital. We sometime... Read more
You Be the Coder:
Colostomy/Colectomy
Test your coding knowledge. Determine how you would code this situation before look... Read more
Colostomy/Colectomy
Test your coding knowledge. Determine how you would code this situation before look... Read more
Four Tips to Optimize Billing for Post-burn Grafts and Flaps
Following treatment, full-thickness burns must be covered to restore the skin barrie... Read more
Following treatment, full-thickness burns must be covered to restore the skin barrie... Read more
Modifier -58 Versus -78 and -79:
Proper Use Explained
Patients often require additional services following a procedure. CPT includes three mod... Read more
Proper Use Explained
Patients often require additional services following a procedure. CPT includes three mod... Read more
HCFA Briefs:
New Modifiers Introduced
HCFA has deleted modifier -GX (service not covered by Medicare) and replaced it with two... Read more
New Modifiers Introduced
HCFA has deleted modifier -GX (service not covered by Medicare) and replaced it with two... Read more
HCFA Briefs:
Medicare Carriers Instructed to Accept Pre-op Clearance V Codes
HCFA has revised section 15047 of the Medicare Carriers Manual (MCM) to ensure local Medi... Read more
Medicare Carriers Instructed to Accept Pre-op Clearance V Codes
HCFA has revised section 15047 of the Medicare Carriers Manual (MCM) to ensure local Medi... Read more
Reader Question:
Modifier -59 With Multiple Colonoscopies
Question: When coding a colonoscopy with snare polypectomy at the cecum and biopsy at the ... Read more
Modifier -59 With Multiple Colonoscopies
Question: When coding a colonoscopy with snare polypectomy at the cecum and biopsy at the ... Read more
Reader Question:
Decision for Surgery Payable Separately
Question: One of my physicians attended a seminar in which he was told if he sees a patien... Read more
Decision for Surgery Payable Separately
Question: One of my physicians attended a seminar in which he was told if he sees a patien... Read more
You Be the Coder:
Nasogastric Tube Placement
Test your coding knowledge. Determine how you would code this situation before loo... Read more
Nasogastric Tube Placement
Test your coding knowledge. Determine how you would code this situation before loo... Read more
Precise Diagnosis Coding, Careful CPT Selection Are Vital When Billing For Burn Treatments
To establish medical necessity for burn treatments, surgeons must supply the correct diag... Read more
To establish medical necessity for burn treatments, surgeons must supply the correct diag... Read more
Screening Colonoscopies Now Covered, but ABN Still Wise
As of July 1, 2001, Medicare will cover screening colonoscopies every 10 years for patient... Read more
As of July 1, 2001, Medicare will cover screening colonoscopies every 10 years for patient... Read more
Reader Question:
Esophageal Balloon and Stent
Question: What are the proper codes for the following procedures: EGD with biopsies of th... Read more
Esophageal Balloon and Stent
Question: What are the proper codes for the following procedures: EGD with biopsies of th... Read more
Reader Question:
44015 Correctly Coded with 48150
Question: Our local Medicare carrier is denying +44015 when performed during the same se... Read more
44015 Correctly Coded with 48150
Question: Our local Medicare carrier is denying +44015 when performed during the same se... Read more
Reader Question:
Rectal Bleeding Versus Blood in Stool
Question: What is the difference between ICD-9 codes 569.3 (hemorrhage of rectum and anus)... Read more
Rectal Bleeding Versus Blood in Stool
Question: What is the difference between ICD-9 codes 569.3 (hemorrhage of rectum and anus)... Read more
Reader Question:
Implant Removal
Question: A patient presents with a palpable breast density, and the surgeon performs an e... Read more
Implant Removal
Question: A patient presents with a palpable breast density, and the surgeon performs an e... Read more
You Be the Coder:
Exploration Without Hernia Repair
Test your coding knowledge. Determine how you would code this situation before looking at... Read more
Exploration Without Hernia Repair
Test your coding knowledge. Determine how you would code this situation before looking at... Read more
Documentation Makes the Difference When Coding Upper GI Endoscopies
Any of more than 20 CPT codes may best describe an upper gastrointestinal (GI) procedure. ... Read more
Any of more than 20 CPT codes may best describe an upper gastrointestinal (GI) procedure. ... Read more
HCFA to Cover PTA/Stent Deployment in Clinical Trials
HCFA has decided to cover balloon angioplasty in the carotid artery performed with deploym... Read more
HCFA has decided to cover balloon angioplasty in the carotid artery performed with deploym... Read more
Op Note Is Crucial for Billing PEG Tube Services
Because they often require replacement and have both a percutaneous and endoscopic compone... Read more
Because they often require replacement and have both a percutaneous and endoscopic compone... Read more
Reader Question:
Washout of Abdomen With Zippered Mesh
"Question: Our surgeon placed mesh with a zipper on an ICU patients abdomen. Subsequently,... Read more
Washout of Abdomen With Zippered Mesh
"Question: Our surgeon placed mesh with a zipper on an ICU patients abdomen. Subsequently,... Read more
Reader Question:
Laparoscopically Assisted Colectomy
Question: How do I code a laparoscopically assisted colectomy? Specifically, my surgeon us... Read more
Laparoscopically Assisted Colectomy
Question: How do I code a laparoscopically assisted colectomy? Specifically, my surgeon us... Read more
Reader Question:
Arthrodesis Cosurgery
Question: Which CPT code should I use when the surgeon undertakes a thoracotomy to prepare... Read more
Arthrodesis Cosurgery
Question: Which CPT code should I use when the surgeon undertakes a thoracotomy to prepare... Read more
You Be the Coder:
Polyp Removals in Different Sections of Stomach
Question: Our surgeon removed two polyps from inside a stomach. One was directly in front ... Read more
Polyp Removals in Different Sections of Stomach
Question: Our surgeon removed two polyps from inside a stomach. One was directly in front ... Read more
Three Tips Help Optimize Billing for Laparoscopic Cholecystectomy
In some situations, a general surgeon may receive additional reimbursement for a laparos... Read more
In some situations, a general surgeon may receive additional reimbursement for a laparos... Read more
Case Study:
Reason for Excision of Coccyx Determines Correct Code
"When a coccygeal decubitus ulcer is excised or debrided, the patients coccyx may also be ... Read more
Reason for Excision of Coccyx Determines Correct Code
"When a coccygeal decubitus ulcer is excised or debrided, the patients coccyx may also be ... Read more
Correction:
Debridement
The March issue of General Surgery Coding Alert incorrectly stated that 11044 (debridement... Read more
Debridement
The March issue of General Surgery Coding Alert incorrectly stated that 11044 (debridement... Read more
Reader Question:
Partial Colectomy Code Describes Ileocolostomy
Question: A presumptive diagnosis of acute appendicitis was made on a patient in the emerg... Read more
Partial Colectomy Code Describes Ileocolostomy
Question: A presumptive diagnosis of acute appendicitis was made on a patient in the emerg... Read more
Reader Question:
Excision of Facial Lipoma
Question: How should I code for the excision of a 2-cm lipoma on the forehead that was lyi... Read more
Excision of Facial Lipoma
Question: How should I code for the excision of a 2-cm lipoma on the forehead that was lyi... Read more
Reader Question:
Should Modifier -51 Be Used?
Question: I have always thought that multiple procedures performed the same day on the sam... Read more
Should Modifier -51 Be Used?
Question: I have always thought that multiple procedures performed the same day on the sam... Read more
Reader Question:
Endoscopy, Colonoscopy During Same Session
Question: The January 2001 General Surgery Coding Alert, p. 3, provides an example of the ... Read more
Endoscopy, Colonoscopy During Same Session
Question: The January 2001 General Surgery Coding Alert, p. 3, provides an example of the ... Read more
Reader Question:
Subsequent Observation Day Billed as Established Outpatient Visit
Question: My physician admitted a female patient for observation with left lower quadrant ... Read more
Subsequent Observation Day Billed as Established Outpatient Visit
Question: My physician admitted a female patient for observation with left lower quadrant ... Read more
You Be the Coder:
Flexible Sigmoidoscopy With Prior Colectomy
Question: Our surgeon performed a flexible sigmoidoscopy through the rectum and into the s... Read more
Flexible Sigmoidoscopy With Prior Colectomy
Question: Our surgeon performed a flexible sigmoidoscopy through the rectum and into the s... Read more
Answer Four Questions to Ensure Appropriate Reimbursement for Decubitus Ulcer Procedures
As many as 25 codes can describe the excision or debridement of a decubitus ulcer. To se... Read more
As many as 25 codes can describe the excision or debridement of a decubitus ulcer. To se... Read more
HCFA Suspends a Portion of 6.3 CCI Edits:
Proper Use of Modifier -25 Remains Crucial for Receiving Optimal Reimbursement
In a memorandum released Feb. 8, 2001, (B-01-09, Change Request 1546) HCFA announced the s... Read more
Proper Use of Modifier -25 Remains Crucial for Receiving Optimal Reimbursement
In a memorandum released Feb. 8, 2001, (B-01-09, Change Request 1546) HCFA announced the s... Read more
Reader Question:
Bail-out Cholangiogram Requires Modifier -53
Question: Our surgeon performed a laparoscopic cholecystectomy and, in the process, made m... Read more
Bail-out Cholangiogram Requires Modifier -53
Question: Our surgeon performed a laparoscopic cholecystectomy and, in the process, made m... Read more
Reader Question:
Lysis of Adhesions
Question: How would I code an exploratory laparotomy with division of adhesive band and ly... Read more
Lysis of Adhesions
Question: How would I code an exploratory laparotomy with division of adhesive band and ly... Read more
Reader Question:
Number of Incisions Key to Hernia Billing
Question: If a surgeon performs a laparoscopic recurrent right inguinal hernia repair, rig... Read more
Number of Incisions Key to Hernia Billing
Question: If a surgeon performs a laparoscopic recurrent right inguinal hernia repair, rig... Read more
Reader Question:
Coding Compliance Plans
Question: I hear that small practices need to implement a coding compliance plan. How does... Read more
Coding Compliance Plans
Question: I hear that small practices need to implement a coding compliance plan. How does... Read more
You Be the Coder:
Hematoma of a Lap Chole
Question: A 54-year-old female patient underwent a laparoscopic cholecystectomy seven days... Read more
Hematoma of a Lap Chole
Question: A 54-year-old female patient underwent a laparoscopic cholecystectomy seven days... Read more
New Codes Increase Payment for Endovascular AAA Repairs and Associated Procedures
Until now, CPT did not include codes to describe endovascular repair of abdominal aortic... Read more
Until now, CPT did not include codes to describe endovascular repair of abdominal aortic... Read more
Find More Essential Coding Information in the HCFA Fee Schedule
The HCFA 2001 fee schedule contains not only information you might expect, such as the num... Read more
The HCFA 2001 fee schedule contains not only information you might expect, such as the num... Read more
HCFA Says No to Modifier -60
HCFA has decided not to recognize modifier -60 (altered surgical field). The new modifier... Read more
HCFA has decided not to recognize modifier -60 (altered surgical field). The new modifier... Read more
Reader Question:
Postoperative Bleeding Repair
Question: When a patient returns to the operating room for postoperative bleeding on the s... Read more
Postoperative Bleeding Repair
Question: When a patient returns to the operating room for postoperative bleeding on the s... Read more
Reader Question:
Foreign Body Removal
Question: What code should I use for the removal of an infected Marlex dual mesh by laparo... Read more
Foreign Body Removal
Question: What code should I use for the removal of an infected Marlex dual mesh by laparo... Read more
You Be the Coder:
Dressing Change
Question: A patient was referred to us with dead skin on his leg caused by an accident wit... Read more
Dressing Change
Question: A patient was referred to us with dead skin on his leg caused by an accident wit... Read more
Choose the Correct Hemorrhoid Removal Code To Receive Optimal Reimbursement
The removal of one or more hemorrhoids can lead to several coding dilemmas for general ... Read more
The removal of one or more hemorrhoids can lead to several coding dilemmas for general ... Read more
HCFA Fee Schedule Provides Essential Coding Information
The Health Care Financing Administration (HCFA) modifies its fee schedule for physicians e... Read more
The Health Care Financing Administration (HCFA) modifies its fee schedule for physicians e... Read more
Insert:
2001 National Physician Fee Schedule Relative Value File
CPT codes and descriptions only are copyright 2000 American Medical Association. All Rig... Read more
2001 National Physician Fee Schedule Relative Value File
CPT codes and descriptions only are copyright 2000 American Medical Association. All Rig... Read more
Reader Question:
Colon Resection With Ileostomy and Mucous Fistula
Question: How should a laparotomy with irrigation of stool and formation of ileostomy with... Read more
Colon Resection With Ileostomy and Mucous Fistula
Question: How should a laparotomy with irrigation of stool and formation of ileostomy with... Read more
Reader Question:
Obstruction Decompression
Question: One of our surgeons recently admitted a patient with an incomplete small bowel ... Read more
Obstruction Decompression
Question: One of our surgeons recently admitted a patient with an incomplete small bowel ... Read more
Reader Question:
Hemigastrectomy
Question: How would you code a hemigastrectomy?Vermont Subscriber Answer: Selecting the ri... Read more
Hemigastrectomy
Question: How would you code a hemigastrectomy?Vermont Subscriber Answer: Selecting the ri... Read more
Reader Question:
Complications Treated in Office
Question: Our physician performed split-thickness skin graft with excision of large skin c... Read more
Complications Treated in Office
Question: Our physician performed split-thickness skin graft with excision of large skin c... Read more
Reader Question:
Modifier -59 or -51?
Question: What is the difference between modifiers -59 and -51? During preparation for the... Read more
Modifier -59 or -51?
Question: What is the difference between modifiers -59 and -51? During preparation for the... Read more
You Be the Coder:
Whipple Procedure and Cholecystectomy
Question: Is it ever appropriate to bill separately for cholecystectomy when performed in ... Read more
Whipple Procedure and Cholecystectomy
Question: Is it ever appropriate to bill separately for cholecystectomy when performed in ... Read more