General Surgery Coding Alert
Are You Reporting 16000-16030 for All Burn Treatments?
These 4 tips will help you get the payment you deserveIf you're relying on the 16000-16030... Read more
These 4 tips will help you get the payment you deserveIf you're relying on the 16000-16030... Read more
For NPP Burn Care, Select 97601/97602
When a nonphysician practitioner (NPP) provides subsequent debridements following escharot... Read more
When a nonphysician practitioner (NPP) provides subsequent debridements following escharot... Read more
Modifiers -58, -78 and -79:
Here's How to Choose the Right One
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Here's How to Choose the Right One
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Self-Quiz:
Test Your Selection Savvy: -58, -78 or -79?
Here's your chance to apply the information you have learned about selecting modifiers -58... Read more
Test Your Selection Savvy: -58, -78 or -79?
Here's your chance to apply the information you have learned about selecting modifiers -58... Read more
Six Must-Have HIPAA Training Skills
You can have all the HIPAA training in the world, but if you're not enforcing and practici... Read more
You can have all the HIPAA training in the world, but if you're not enforcing and practici... Read more
Don't Let Home Coding Turn Into a Code Red
Just because you're coding from home doesn't mean you don't have to be HIPAA-compliant.&nb... Read more
Just because you're coding from home doesn't mean you don't have to be HIPAA-compliant.&nb... Read more
11 Ways to Minimize Fax and E-Mail Risks
If you want to stay out of the courthouse and the newspapers, follow these personal health... Read more
If you want to stay out of the courthouse and the newspapers, follow these personal health... Read more
Reader Question:
Don't Confuse 'XXX' and '000' Global Periods
Question: What's the difference between an "XXX" global period and a "000" global period?I... Read more
Don't Confuse 'XXX' and '000' Global Periods
Question: What's the difference between an "XXX" global period and a "000" global period?I... Read more
Reader Question:
Five Rules Guide Dermabond Repairs
Question: Can I report G0168 when I use Dermabond for a simple laceration repair? What if ... Read more
Five Rules Guide Dermabond Repairs
Question: Can I report G0168 when I use Dermabond for a simple laceration repair? What if ... Read more
Reader Question:
Use Modifiers for Multiple Catheter Attempts
Question: The surgeon must place a central catheter (36489). After unsuccessfully attempti... Read more
Use Modifiers for Multiple Catheter Attempts
Question: The surgeon must place a central catheter (36489). After unsuccessfully attempti... Read more
Reader Question:
Report 37620 and 75940 for IVC Filter
Question: How can I get paid for inferior vena cava (IVC) filter placement? Medicare is pa... Read more
Report 37620 and 75940 for IVC Filter
Question: How can I get paid for inferior vena cava (IVC) filter placement? Medicare is pa... Read more
Reader Question:
Don't Charge Separately for CVC Removal
Question: How can I get paid for removal of a central venous catheter (CVC)?Nevada Subscri... Read more
Don't Charge Separately for CVC Removal
Question: How can I get paid for removal of a central venous catheter (CVC)?Nevada Subscri... Read more
Reader Question:
Rely on Unlisted-Procedure Code for Laparoscopy Ventral Hernia Repair
Question: How can I report laparoscopic ventral hernia repair? Code 49560 seems closest, b... Read more
Rely on Unlisted-Procedure Code for Laparoscopy Ventral Hernia Repair
Question: How can I report laparoscopic ventral hernia repair? Code 49560 seems closest, b... Read more
Reader Question :
Save Yourself Construction Costs
Question: Are physical barriers available to prevent patients and visitors from viewing co... Read more
Save Yourself Construction Costs
Question: Are physical barriers available to prevent patients and visitors from viewing co... Read more
You Be the Coder:
Charging for Radiology Procedures
Question: A patient presented for follow-up four months after surgery. The physician provi... Read more
Charging for Radiology Procedures
Question: A patient presented for follow-up four months after surgery. The physician provi... Read more
Are You Billing the Right ICD-9 Codes for Burns?
5 Guidelines you should alwaysfollow If you're finding that assigning burn diagno... Read more
5 Guidelines you should alwaysfollow If you're finding that assigning burn diagno... Read more
Apply the 'Rule of Nines' With Better Than 99.99% Accuracy
To assign the required fourth and fifth digits for diagnosis category 948.xx, you must app... Read more
To assign the required fourth and fifth digits for diagnosis category 948.xx, you must app... Read more
CMS Has Change of Heart on Proposed 'Mass Adjustment'
Good news for your surgery practice: You won't have to repay overpayments from CMS' delaye... Read more
Good news for your surgery practice: You won't have to repay overpayments from CMS' delaye... Read more
Billing 'Starred' Procedures:
Report E/M Services During Global Periods to Boost Payment
What if you could bill for services, such as follow-up E/M care, that are part of global s... Read more
Report E/M Services During Global Periods to Boost Payment
What if you could bill for services, such as follow-up E/M care, that are part of global s... Read more
Beyond the Three R's
Experts advise you on choosing a consult categoryAfter you've documented a request, reason... Read more
Experts advise you on choosing a consult categoryAfter you've documented a request, reason... Read more
Subsequent Hospital Care:
Think 99231 Is the Only Option? Think Again
4 tips could keep your practice from losing more than $2,400If you report 99231 for all of... Read more
Think 99231 Is the Only Option? Think Again
4 tips could keep your practice from losing more than $2,400If you report 99231 for all of... Read more
Payment for an ED Visit and a Hospital Admit on the Same Day?
Here's howHow can you code for optimal reimbursement if the surgeon sees a patient in the ... Read more
Here's howHow can you code for optimal reimbursement if the surgeon sees a patient in the ... Read more
Using Documentation Templates? Read This First
You have to base your ICD-9 coding on your physician's documentation, but that doesn't mea... Read more
You have to base your ICD-9 coding on your physician's documentation, but that doesn't mea... Read more
Learn the Fine Points of Coding Critical Care
Get more out of 99291 and 99292Insufficient physician documentation - not your coding skil... Read more
Get more out of 99291 and 99292Insufficient physician documentation - not your coding skil... Read more
Reader Question:
Bill Bronchoscopy With Thoracotomy
Question: Can I bill bronchoscopy with thoracotomy? North Carolina Subscriber Answer: A su... Read more
Bill Bronchoscopy With Thoracotomy
Question: Can I bill bronchoscopy with thoracotomy? North Carolina Subscriber Answer: A su... Read more
Reader Question:
Hematoma Isn't a Complication
Question: Six days ago, a patient underwent a laparoscopic cholecystectomy. Since then, th... Read more
Hematoma Isn't a Complication
Question: Six days ago, a patient underwent a laparoscopic cholecystectomy. Since then, th... Read more
Reader Question:
Use 'M' Codes at Payer/Facility Request
Question: What are "M" codes? Should I use them and, if so, when? Californi... Read more
Use 'M' Codes at Payer/Facility Request
Question: What are "M" codes? Should I use them and, if so, when? Californi... Read more
Reader Question:
90846 Describes Psychiatric Services Only
Question: May I report 90846 if a physician meets with a patient's family to discuss treat... Read more
90846 Describes Psychiatric Services Only
Question: May I report 90846 if a physician meets with a patient's family to discuss treat... Read more
Reader Question:
Include Chart Review in E/M
Question: A patient had her past medical records, containing more than 10 years of history... Read more
Include Chart Review in E/M
Question: A patient had her past medical records, containing more than 10 years of history... Read more
Reader Question:
2 Lesions? Code for Both
Question: The surgeon excised two benign lesions of about the same size (roughly 0.8 cm) f... Read more
2 Lesions? Code for Both
Question: The surgeon excised two benign lesions of about the same size (roughly 0.8 cm) f... Read more
Reader Question:
No Incision, No Modifier -53?
Question: Prior to surgery, we established general anesthesia, but the patient began breat... Read more
No Incision, No Modifier -53?
Question: Prior to surgery, we established general anesthesia, but the patient began breat... Read more
Reader Question:
Render an Opinion on Confirmatory Consults
Question: Can a transfer of service take place when we conduct a confirmatory consult? How... Read more
Render an Opinion on Confirmatory Consults
Question: Can a transfer of service take place when we conduct a confirmatory consult? How... Read more
Reader Question:
Who Specified What?
Question: What do "NEC" and "NOS" mean in ICD-9 coding? How should I select between them?F... Read more
Who Specified What?
Question: What do "NEC" and "NOS" mean in ICD-9 coding? How should I select between them?F... Read more
You Be the Coder:
Signs and Symptoms or 'Rule-Out' Diagnosis?
Question: The surgeon saw a pediatric patient in the ED with a very high fever and suspect... Read more
Signs and Symptoms or 'Rule-Out' Diagnosis?
Question: The surgeon saw a pediatric patient in the ED with a very high fever and suspect... Read more
Part 2:
3 Expert Tips Help Make the Most of Hemorrhoid Removal Procedures
Do you know a fissurectomy from a fistulectomy from a fistulotomy? And how would you code ... Read more
3 Expert Tips Help Make the Most of Hemorrhoid Removal Procedures
Do you know a fissurectomy from a fistulectomy from a fistulotomy? And how would you code ... Read more
Hemorrhoidectomies:
How to Expand Your Billing Opportunities
Are endoscopic and E/M services bundled to hemorrhoidectomy procedures? In some cases they... Read more
How to Expand Your Billing Opportunities
Are endoscopic and E/M services bundled to hemorrhoidectomy procedures? In some cases they... Read more
Billing Consults:
3 Words You Can't Do Without
Quick: What three requirements distinguish a consult (99241-99263) from other inpatient an... Read more
3 Words You Can't Do Without
Quick: What three requirements distinguish a consult (99241-99263) from other inpatient an... Read more
Use Modifier -32 to Report Confirmatory Consults
Not every type of consult must meet the same requirements. Specifically, physicians provid... Read more
Not every type of consult must meet the same requirements. Specifically, physicians provid... Read more
Coding Case Study:
Amputation Following Bypass Is a 'Staged' Procedure
The Procedure: A 46-year-old male undergoes bypass graft (35661) for artherosclerotic car... Read more
Amputation Following Bypass Is a 'Staged' Procedure
The Procedure: A 46-year-old male undergoes bypass graft (35661) for artherosclerotic car... Read more
Think You've Made Your Case for Modifier -22? Not if You Haven't Done These 5 Things
If you're submitting claims for unusual procedural services without first determining how ... Read more
If you're submitting claims for unusual procedural services without first determining how ... Read more
Test Yourself:
Opt for -22 Over an Unlisted-Procedure Code
Question: Our physician asks us to report procedures that take extra time and effort wit... Read more
Opt for -22 Over an Unlisted-Procedure Code
Question: Our physician asks us to report procedures that take extra time and effort wit... Read more
Reader Question:
Use -57 for Admission and Same-Day Procedure
Question: May I report a hospital admission and procedure on the same day? My payer has b... Read more
Use -57 for Admission and Same-Day Procedure
Question: May I report a hospital admission and procedure on the same day? My payer has b... Read more
Reader Question:
Submit Modifier -GA When You Use an ABN
Question: Do we have to report modifiers -GA and -GX for all claims that we know Medicare... Read more
Submit Modifier -GA When You Use an ABN
Question: Do we have to report modifiers -GA and -GX for all claims that we know Medicare... Read more
Reader Question:
Report 43631 or 43638 for Hemigastrectomy
Question: What is hemigastrectomy, and how should I code for it? Arizona Subscriber Answe... Read more
Report 43631 or 43638 for Hemigastrectomy
Question: What is hemigastrectomy, and how should I code for it? Arizona Subscriber Answe... Read more
Reader Question:
Choose Your Coding Poison Based on Documentation
Question: How should I decide whether managing excessive bleeding that requires extra phys... Read more
Choose Your Coding Poison Based on Documentation
Question: How should I decide whether managing excessive bleeding that requires extra phys... Read more
You Be the Coder:
Look to CPT for 'Primary' Codes
Question: Which codes are "primary" for add-on code 44139? May I report it with total abdo... Read more
Look to CPT for 'Primary' Codes
Question: Which codes are "primary" for add-on code 44139? May I report it with total abdo... Read more
Part 1:
Are You Reporting Hemorrhoid Removal Correctly? 5 Expert Tips Make It Easy
Can you easily distinguish among the nine CPT codes (46221-46262) that describe hemor... Read more
Are You Reporting Hemorrhoid Removal Correctly? 5 Expert Tips Make It Easy
Can you easily distinguish among the nine CPT codes (46221-46262) that describe hemor... Read more
Get the Pay You Deserve in Group Practice Coding
How can you code if a physician in your group practice treats a patient during the global ... Read more
How can you code if a physician in your group practice treats a patient during the global ... Read more
CMS Unveils New ICD-9 Codes:
More Precision for Converted Surgeries, Muscle Weakness
New ICD-9 codes for 2004 will allow you to report several conditions or circumstances, inc... Read more
More Precision for Converted Surgeries, Muscle Weakness
New ICD-9 codes for 2004 will allow you to report several conditions or circumstances, inc... Read more
You Be The Coder:
Can 10160 Include Seroma Drainage?
Reviewed on May 6, 2015 Question: Our surgeon drains breast seromas using a large... Read more
Can 10160 Include Seroma Drainage?
Reviewed on May 6, 2015 Question: Our surgeon drains breast seromas using a large... Read more
Reader Question:
Surgical Scope Always Includes Diagnostic Scope
Question: The surgeon performed diagnostic thoracoscopy followed by surgical thoracoscopy ... Read more
Surgical Scope Always Includes Diagnostic Scope
Question: The surgeon performed diagnostic thoracoscopy followed by surgical thoracoscopy ... Read more
Reader Question:
Documentation Supports Code for Mesh Removal
Question: Our surgeon operated on a patient with recurrent inguinal hernia. The mesh place... Read more
Documentation Supports Code for Mesh Removal
Question: Our surgeon operated on a patient with recurrent inguinal hernia. The mesh place... Read more
Reader Question:
Number of Lines Matters for Modifier -59
Question: I reported 10021-59 x 2 for two separate aspirations on the same breast. Medicar... Read more
Number of Lines Matters for Modifier -59
Question: I reported 10021-59 x 2 for two separate aspirations on the same breast. Medicar... Read more
Reader Question:
Musculoskeletal Codes Are Possible for Lipomas
Question: For reporting lipoma removal, which codes are correct: the benign lesion codes, ... Read more
Musculoskeletal Codes Are Possible for Lipomas
Question: For reporting lipoma removal, which codes are correct: the benign lesion codes, ... Read more
Part 2:
Want to Improve Coding Accuracy for Sentinel Node Biopsies? Count Incisions, Not Excisions
Although it may seem counterintuitive, you don't bill for sentinel node biopsies accordin... Read more
Want to Improve Coding Accuracy for Sentinel Node Biopsies? Count Incisions, Not Excisions
Although it may seem counterintuitive, you don't bill for sentinel node biopsies accordin... Read more
Modifier -62:
Cooperation in the OR Requires Coding Cooperation, Too
Coding can become tricky when two surgeons work together during the same surgery. Medicare... Read more
Cooperation in the OR Requires Coding Cooperation, Too
Coding can become tricky when two surgeons work together during the same surgery. Medicare... Read more
Global Periods, Part 2:
To Bill or Not to Bill? Handle Complications the Right Way
Although not uncommon, complications following surgery are an uncommonly troublesome codin... Read more
To Bill or Not to Bill? Handle Complications the Right Way
Although not uncommon, complications following surgery are an uncommonly troublesome codin... Read more
Reader Questions:
Sigmoidoscopy Is Not Reduced Colonoscopy
Question: The surgeon performed a colonoscopy to 80 cm for tumor marking. Should I report ... Read more
Sigmoidoscopy Is Not Reduced Colonoscopy
Question: The surgeon performed a colonoscopy to 80 cm for tumor marking. Should I report ... Read more
Reader Questions:
Take Your Pick of 95 or 97 Guidelines
Question: Which guidelines for E/M documentation (1995 or 1997) should we use when reviewi... Read more
Take Your Pick of 95 or 97 Guidelines
Question: Which guidelines for E/M documentation (1995 or 1997) should we use when reviewi... Read more
Reader Questions:
Reporting Critical Care for Multiple Physicians
Question: My practice has a heavy trauma volume and manages critical care issues for patie... Read more
Reporting Critical Care for Multiple Physicians
Question: My practice has a heavy trauma volume and manages critical care issues for patie... Read more
Reader Questions:
You Probably Cant Bill Canceled Surgery
Question: A patient was intubated, and general anesthesia was established. But despite eff... Read more
You Probably Cant Bill Canceled Surgery
Question: A patient was intubated, and general anesthesia was established. But despite eff... Read more
Reader Questions:
Multiple Lesions Dont Always Require Multiple Scope Codes
Question: I am new to coding colonoscopies. If the surgeon biopsies multiple polyps in dif... Read more
Multiple Lesions Dont Always Require Multiple Scope Codes
Question: I am new to coding colonoscopies. If the surgeon biopsies multiple polyps in dif... Read more
You Be the Coder:
What Goes With 44015?
Question: To which primary codes may I attach add-on-code 44015? North Caro... Read more
What Goes With 44015?
Question: To which primary codes may I attach add-on-code 44015? North Caro... Read more
Part 1:
Visualize Better Payment for Sentinel Node Biopsy Procedures
Although the AMA and CPT state that you shouldnt use 38792 and 78195 during the same sess... Read more
Visualize Better Payment for Sentinel Node Biopsy Procedures
Although the AMA and CPT state that you shouldnt use 38792 and 78195 during the same sess... Read more
Part 1:
Understand Global Periods and Avoid a World of Hurt
So-called "global" periods which define a package of services or care associated with and... Read more
Understand Global Periods and Avoid a World of Hurt
So-called "global" periods which define a package of services or care associated with and... Read more
CCI 9.1:
New Companions for Caths,Pancreatic Procedures
Of the more than 4,700 changes to the national Correct Coding Initiative (CCI) this quarte... Read more
New Companions for Caths,Pancreatic Procedures
Of the more than 4,700 changes to the national Correct Coding Initiative (CCI) this quarte... Read more
Global-Period Lengths Vary
Under Medicare guidelines as established by the Physician Fee Schedule, there are four p... Read more
Under Medicare guidelines as established by the Physician Fee Schedule, there are four p... Read more
Correction:
BundledJejunostomy and Mesh Removal
The February 2003 General Surgery Coding Alert ("Watch for Bundled Jejunostomy") should h... Read more
BundledJejunostomy and Mesh Removal
The February 2003 General Surgery Coding Alert ("Watch for Bundled Jejunostomy") should h... Read more
Keep an Eye on Observation Coding to Avoid Blurry E/M Reporting
Many general surgery coders have no trouble following CPT rules for hospital observation ... Read more
Many general surgery coders have no trouble following CPT rules for hospital observation ... Read more
3 Guidelines for Better Discharge Reimbursement
General surgery coders may not use hospital discharge services codes often, but when the... Read more
General surgery coders may not use hospital discharge services codes often, but when the... Read more
Emphasize Surgeons Expertise To Increase Concurrent Care Pay
When a surgeon works concurrently with other physicians to treat a patient, you'll stand ... Read more
When a surgeon works concurrently with other physicians to treat a patient, you'll stand ... Read more
READER QUESTION:
Medicare Specifies -AS for PAs in Surgery
Question: In the past, Ive always reported modifier -80 for a certified PA in the operati... Read more
Medicare Specifies -AS for PAs in Surgery
Question: In the past, Ive always reported modifier -80 for a certified PA in the operati... Read more
READER QUESTION:
Significant Additional Work Warrants -22
Question: If the physician spends an additional 30 minutes lysing adhesions during a lapa... Read more
Significant Additional Work Warrants -22
Question: If the physician spends an additional 30 minutes lysing adhesions during a lapa... Read more
READER QUESTION:
No Fixed Guidelines for -63
Question: What can you tell me about the new-for-2003 modifier -63? Georgia Subscriber An... Read more
No Fixed Guidelines for -63
Question: What can you tell me about the new-for-2003 modifier -63? Georgia Subscriber An... Read more
READER QUESTION:
Include Consult in ED Observation
Question: If the emergency department (ED) physician requests a consultation from a surge... Read more
Include Consult in ED Observation
Question: If the emergency department (ED) physician requests a consultation from a surge... Read more
READER QUESTION:
Treat Two-Surgeon Visits Individually
Question: How should we report the following situation: Dr. Afrom our surgery group admit... Read more
Treat Two-Surgeon Visits Individually
Question: How should we report the following situation: Dr. Afrom our surgery group admit... Read more
READER QUESTION:
Same-Day Discharges Get Single Code
Question: One of our surgeons saw a patient in the hospital and coded the visit as 99233 ... Read more
Same-Day Discharges Get Single Code
Question: One of our surgeons saw a patient in the hospital and coded the visit as 99233 ... Read more
READER QUESTION:
Pre-Op Visits Require Medical Necessity
Question: Our surgeon wants to send a patient back to her primary-care physician (PCP) fo... Read more
Pre-Op Visits Require Medical Necessity
Question: Our surgeon wants to send a patient back to her primary-care physician (PCP) fo... Read more
READER QUESTION:
Report NP Work for Surgical Assist
Question: Two providers (one a surgeon and the other a nurse practitioner [NP]) worked to... Read more
Report NP Work for Surgical Assist
Question: Two providers (one a surgeon and the other a nurse practitioner [NP]) worked to... Read more
You Be The Coder:
Get Preauthorization for Varicose Vein Injections
Question: Payers routinely reject our claims for varicose vein injections. What are we do... Read more
Get Preauthorization for Varicose Vein Injections
Question: Payers routinely reject our claims for varicose vein injections. What are we do... Read more
You Be the Coder:
Face-to-Face Time During Counseling Sessions
Question: Our surgeon spent time during an office visit counseling a new patient prior to... Read more
Face-to-Face Time During Counseling Sessions
Question: Our surgeon spent time during an office visit counseling a new patient prior to... Read more
Endovascular AAA Repairs, Part 2:
Complete Your Reimbursement by Claiming All Separately Reportable Procedures
Endovascular repair of abdominal aortic aneurysms (AAA) involves a range of ... Read more
Complete Your Reimbursement by Claiming All Separately Reportable Procedures
Endovascular repair of abdominal aortic aneurysms (AAA) involves a range of ... Read more
News You Can Use:
Medicare Payments on the Rebound, but Expect Challenges
On Feb. 28, Medicare published an update to its final rule for the 2003 Physician Fee Sc... Read more
Medicare Payments on the Rebound, but Expect Challenges
On Feb. 28, Medicare published an update to its final rule for the 2003 Physician Fee Sc... Read more
Distinguishing Modifiers -80, -81, -82 and -AS
Surgeons often use assistants in the operating room, but with three CPT modifiers (-80, -8... Read more
Surgeons often use assistants in the operating room, but with three CPT modifiers (-80, -8... Read more
Reader Question:
Use 64640 for Botox Treatment
Question: How should I code for treatment of an anal fissure with Botox? North Carolina ... Read more
Use 64640 for Botox Treatment
Question: How should I code for treatment of an anal fissure with Botox? North Carolina ... Read more
Reader Question:
Use -25 for E/M and Scope on the Same Day
Question: May we report a diagnostic endoscopy and E/M service on the same day? The paye... Read more
Use -25 for E/M and Scope on the Same Day
Question: May we report a diagnostic endoscopy and E/M service on the same day? The paye... Read more
Reader Question:
Report Open Procedure When Converting
Question: How should I code if the physician must convert a laparoscopic cholecystectom... Read more
Report Open Procedure When Converting
Question: How should I code if the physician must convert a laparoscopic cholecystectom... Read more
You Be the Coder:
Waiting for Report Isnt Standby Time
Test your coding knowledge. Determine how you would code this situation before looking a... Read more
Waiting for Report Isnt Standby Time
Test your coding knowledge. Determine how you would code this situation before looking a... Read more
Part 1:
Earn Straight As When Reporting Endovascular AAA Repairs
Although you may find reporting endovascular repair of abdominal aortic aneurysms (AAA)... Read more
Earn Straight As When Reporting Endovascular AAA Repairs
Although you may find reporting endovascular repair of abdominal aortic aneurysms (AAA)... Read more
Im Not Supposed to Be Here!:
Getting Paid After-Hours
After-hours codes 99050-99054 are designed to reimburse physicians who see patients at ... Read more
Getting Paid After-Hours
After-hours codes 99050-99054 are designed to reimburse physicians who see patients at ... Read more
Watch the Clock for Higher E/M Reimbursement
Lengthy but low-level E/M visits or time spent reassuring and counseling patients in th... Read more
Lengthy but low-level E/M visits or time spent reassuring and counseling patients in th... Read more
Reader Question:
Tissue Removal Determines Excision Code
Question: Which code is appropriate for lump-ectomy? I've heard conflicting advice regar... Read more
Tissue Removal Determines Excision Code
Question: Which code is appropriate for lump-ectomy? I've heard conflicting advice regar... Read more
Reader Question:
New NPP Rules Affect Hospital,Not Office,E/Ms
Question: I've heard that CMS issued a memorandum regarding new nonphysician practitione... Read more
New NPP Rules Affect Hospital,Not Office,E/Ms
Question: I've heard that CMS issued a memorandum regarding new nonphysician practitione... Read more
Reader Question:
Bill Separately for Physician-Inserted IV Needle?
Question: If the nurse can't start an IV on a pediatric (3-year-old) patient, can the su... Read more
Bill Separately for Physician-Inserted IV Needle?
Question: If the nurse can't start an IV on a pediatric (3-year-old) patient, can the su... Read more
Reader Question:
99356-99357 OK for Unresponsive Patient
Question: If a patient has had a stroke and cannot communicate or is otherwise unrespons... Read more
99356-99357 OK for Unresponsive Patient
Question: If a patient has had a stroke and cannot communicate or is otherwise unrespons... Read more
You Be the Coder:
Is 49085 Correct for Mesh Removal?
Test your coding knowledge. Determine how you would code this situation before looking a... Read more
Is 49085 Correct for Mesh Removal?
Test your coding knowledge. Determine how you would code this situation before looking a... Read more
Cut Out the Confusion of Lesion Excisions
For 2003, CPT significantly revises its guidelines for reporting excision of benign (1... Read more
For 2003, CPT significantly revises its guidelines for reporting excision of benign (1... Read more
Repairs with Lesion Excision Arent an Open-and-Shut Case
Physicians and coders should remember that in most cases, lesion excision will include... Read more
Physicians and coders should remember that in most cases, lesion excision will include... Read more
Watch Incision versus Margins When Calculating Diameter
When calculating excision diameter, be careful not to confuse the length of the incisio... Read more
When calculating excision diameter, be careful not to confuse the length of the incisio... Read more
Documentation Requirements Ease for Teaching Physicians
By Eric Sandham, CPC Under new Medicare rules, teaching physicians will find it easie... Read more
By Eric Sandham, CPC Under new Medicare rules, teaching physicians will find it easie... Read more
Keep Tabs on Surgeons Whereabouts to Avoid Incident-To Snafus
A surgeon's phone call is not enough to allow a surgery practice to bill "incident-to"... Read more
A surgeon's phone call is not enough to allow a surgery practice to bill "incident-to"... Read more
CMS Allows Incident-To Billing for Shared E/M Services
Thanks to a recent CMS revision to its E/M rules, general surgery practices stand to ga... Read more
Thanks to a recent CMS revision to its E/M rules, general surgery practices stand to ga... Read more
Medical Necessity Is Critical for 99211 Reimbursement
Do patients come into the office for blood pressure checks or other brief E/M services ... Read more
Do patients come into the office for blood pressure checks or other brief E/M services ... Read more
Test Yourself:
A 99211 Coding Checkup
How much do you really know about when to report code 99211? Take the following short... Read more
A 99211 Coding Checkup
How much do you really know about when to report code 99211? Take the following short... Read more
Reader Question:
Use Modifier -78 with Wound Dehiscence
Question: The wound repair article in your December 2002 issue failed to mention wound d... Read more
Use Modifier -78 with Wound Dehiscence
Question: The wound repair article in your December 2002 issue failed to mention wound d... Read more
Reader Question:
Check with Payer Before Applying Modifier -66
Question: Are there any special requirements for appending modifier -66? Maine Subscribe... Read more
Check with Payer Before Applying Modifier -66
Question: Are there any special requirements for appending modifier -66? Maine Subscribe... Read more
Reader Question:
Private Payers May Reimburse Telephone Codes
Question: Our physician spent 20 minutes during office hours on the phone providing adv... Read more
Private Payers May Reimburse Telephone Codes
Question: Our physician spent 20 minutes during office hours on the phone providing adv... Read more
Reader Question:
Conscious Sedation
Question: I have read that conscious sedation by a physician performing an endoscopy is ... Read more
Conscious Sedation
Question: I have read that conscious sedation by a physician performing an endoscopy is ... Read more
Reader Question:
When Converting, Report Only the Open Procedure
Question: How should I code if the surgeon must convert to an open procedure during lapa... Read more
When Converting, Report Only the Open Procedure
Question: How should I code if the surgeon must convert to an open procedure during lapa... Read more
Reader Question:
99211 Isnt Just for Nurses
Question: We employ a physician assistant (PA) who performs all levels of E/M services. W... Read more
99211 Isnt Just for Nurses
Question: We employ a physician assistant (PA) who performs all levels of E/M services. W... Read more
Reader Question:
Use HCPCS Modifiers to Report PA Surgery Assist
Question: When a physician assistant (PA) assists in surgery on an outpatient basis, doe... Read more
Use HCPCS Modifiers to Report PA Surgery Assist
Question: When a physician assistant (PA) assists in surgery on an outpatient basis, doe... Read more
Reader Question:
Physician Oversight Required for Critical Care
Question: Is it appropriate to include the time that our PA spends with a patients spouse... Read more
Physician Oversight Required for Critical Care
Question: Is it appropriate to include the time that our PA spends with a patients spouse... Read more
Reader Question:
Dual Diagnosis Presents Incident-To Options
Question: A physician assistant (PA) or a nurse practitioner (NP) is treating a patient i... Read more
Dual Diagnosis Presents Incident-To Options
Question: A physician assistant (PA) or a nurse practitioner (NP) is treating a patient i... Read more
Reader Question:
Bill Incident-To the Resident Doc
Question: One of our doctors treated a patient for an abscess at the site of an arteriov... Read more
Bill Incident-To the Resident Doc
Question: One of our doctors treated a patient for an abscess at the site of an arteriov... Read more
You Be the Coder:
Watch Dx and Modifiers with Thrombectomy
Test your coding knowledge. Determine how you would code this situation before looking a... Read more
Watch Dx and Modifiers with Thrombectomy
Test your coding knowledge. Determine how you would code this situation before looking a... Read more
Be in the Know for 2003:
CPT Adds More New Codes, Greater Specificity
Along with the important changes covered last month, CPT 2003 has added or replaced do... Read more
CPT Adds More New Codes, Greater Specificity
Along with the important changes covered last month, CPT 2003 has added or replaced do... Read more
CCI Update:
More Bundled Injections, Infusions and Catheterizations
Among the approximately 40,000 revisions in version 9.0 of the Correct Coding Initiativ... Read more
More Bundled Injections, Infusions and Catheterizations
Among the approximately 40,000 revisions in version 9.0 of the Correct Coding Initiativ... Read more
Expect Lower Payments in 2003
CMS has announced a reduction in the national Physician Fee Schedule conversion factor t... Read more
CMS has announced a reduction in the national Physician Fee Schedule conversion factor t... Read more
Reader Question:
Lipoma Removal Can Be Coded Several Ways
Question: I've been told that lipoma removals are always coded from the musculoskeletal ... Read more
Lipoma Removal Can Be Coded Several Ways
Question: I've been told that lipoma removals are always coded from the musculoskeletal ... Read more
Reader Question:
Report 46221 Only Once Per Session
Question: If the physician removes multiple hemorrhoids using simple ligature, should I ... Read more
Report 46221 Only Once Per Session
Question: If the physician removes multiple hemorrhoids using simple ligature, should I ... Read more
Reader Question:
Distinguish Consult from Established Patient Visit
Question: An internist requested a consult for an elderly patient with lower gastrointes... Read more
Distinguish Consult from Established Patient Visit
Question: An internist requested a consult for an elderly patient with lower gastrointes... Read more
Reader Question:
Watch for Bundled Jejunostomy
Watch for 'Bundled' Jejunostomy Question: May we report jejunostomy separately with a W... Read more
Watch for Bundled Jejunostomy
Watch for 'Bundled' Jejunostomy Question: May we report jejunostomy separately with a W... Read more
Reader Question:
Use Modifier -50 on Most Bilateral Hernias
Question: I've heard conflicting advice on whether I should append modifier -50 to herni... Read more
Use Modifier -50 on Most Bilateral Hernias
Question: I've heard conflicting advice on whether I should append modifier -50 to herni... Read more
Reader Question:
Bill Separately for Central Venous Line
Question: May we bill separately for a central venous line (36489) placed at the same tim... Read more
Bill Separately for Central Venous Line
Question: May we bill separately for a central venous line (36489) placed at the same tim... Read more
You Be the Coder:
Categorize Uncertain Lesions as Benign
Test your coding knowledge. Determine how you would code this situation before looking a... Read more
Categorize Uncertain Lesions as Benign
Test your coding knowledge. Determine how you would code this situation before looking a... Read more
CPT 2003 Brings Big Changes, Important New Codes and Numerous Refinements
Changes in CPT 2003 will allow surgeons to include margins when measuring lesion size,... Read more
Changes in CPT 2003 will allow surgeons to include margins when measuring lesion size,... Read more
Get Paid for Co-Surgery With Instrumentation Procedures
For 2003, CPT revises the instructional text accompanying codes in its "Spine (Vertebral C... Read more
For 2003, CPT revises the instructional text accompanying codes in its "Spine (Vertebral C... Read more
OIGs 2003 Work Plan Is Now Available on the Web
The U.S. Office of Inspector General (OIG) has released its Work Plan for 2003, which tar... Read more
The U.S. Office of Inspector General (OIG) has released its Work Plan for 2003, which tar... Read more
Critical Care Codes Undergo Revisions for 2003
Revisions to critical care codes in CPT 2003 mean that general surgeons can more accurat... Read more
Revisions to critical care codes in CPT 2003 mean that general surgeons can more accurat... Read more
Medicare Update:
Retroactive Revisions Could Increase Your Payments
A recent Medicare policy decision could allow you to collect additional reimbursement for... Read more
Retroactive Revisions Could Increase Your Payments
A recent Medicare policy decision could allow you to collect additional reimbursement for... Read more
Reader Question:
Match E/M and Place-of-Service Codes
Question: One of my physicians was asked to see a patient in a nursing home. We reported ... Read more
Match E/M and Place-of-Service Codes
Question: One of my physicians was asked to see a patient in a nursing home. We reported ... Read more
Reader Question:
Scar Revision Coding Depends on Documentation
Question: The surgeon performed a bilateral mastectomy on a patient and has scheduled her... Read more
Scar Revision Coding Depends on Documentation
Question: The surgeon performed a bilateral mastectomy on a patient and has scheduled her... Read more
Reader Question:
Always Demonstrate Three Rsfor Consults
Question: Can we report a consult if an emergency department (ED) physician refers a pati... Read more
Always Demonstrate Three Rsfor Consults
Question: Can we report a consult if an emergency department (ED) physician refers a pati... Read more
Reader Question:
Charge for Operating Microscope With Endarterectomy
Question: May I report 69990 separately with 35301 for carotid endarterectomy? Indiana S... Read more
Charge for Operating Microscope With Endarterectomy
Question: May I report 69990 separately with 35301 for carotid endarterectomy? Indiana S... Read more
You Be the Coder:
Use Modifier -22 for Complications
Test your coding knowledge. Determine how you would code this situation before looking a... Read more
Use Modifier -22 for Complications
Test your coding knowledge. Determine how you would code this situation before looking a... Read more