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General Surgery Coding Alert

Integumentary System:
11008: Could This Be the Mesh Removal Code You've Been Waiting For?
CPT also adds new codes for APBI catheter, debridementRevisions to integumentary system co... Read more
Digestive System:
No More Unlisted-Procedure Codes for Laparoscopic Gastric Bypass
Now you can also describe less-than-total colonoscopyIf you've been struggling to bill for... Read more
Cardiovascular System:
New AAA Repair Codes Top the List of Vascular Changes
You'll also have a choice of 4 ablation therapy and 2 transcather codes in 2005You'll have... Read more
NCCI Update:
Reporting Guidance Procedures Just Got Tougher
Edits close the door on 76003 and 76942 with dozens of codes The latest National Correct ... Read more
CMS Revises Mastectomy and Sentinel Node Biopsy Policy
NCCI 10.3 instructs surgeons to report 38500, 38525-38530 with 19160If you've strictly adh... Read more
Look for More CPT 2005 Updates Next Issue!
With so much news on CPT 2005, we weren't able to pack it all in to a single issue. Look t... Read more
4 Rules Repair Your Laceration Coding
Experts reveal when to report intermediate repair codes If you resort to simple repai... Read more
Test Your Laceration Coding Know-How
Determine how you would code these repairsIf you're unsure about how to report laceration ... Read more
You Be the Expert:
Suture Removal
Question: A patient came to have sutures removed from a superficial 1-cm laceration on his... Read more
Reader Question:
Time, Documentation Critical to 99291 Payment
Question: In the afternoon, our surgeon saw a patient for 30 minutes on the hospital floor... Read more
Reader Question:
Why Excisions Don't Add Up
Question: Would you please explain adding excision sizes together? If the physician excise... Read more
You Be the Coder:
Colostomy Takedown With Re-Anastomosis
Reviewed on May 15, 2015; no changes to content   Question: How should I r... Read more
4 Case Studies Demonstrate the Ins and Outs of Foreign-Body Removal
FBR doesn't always mean a 20000-series code CPT does not employ a uniform set of guideline... Read more
Want the Key to Workers' Comp Claims? Try E codes
WC insurers expect information about the accident or disease's cause If your surgeon is s... Read more
Select 99455-99456 - Not E/Ms - for WC Evaluations
If your surgeon evaluates a patient for a workers' compensation claim, you should turn to ... Read more
Skip Modifier -59 for Repeat Procedures
Append -76 for repeats, but not for multiple select catheterizations Not all multiple pro... Read more
Correction:
Global Days for 11044
The July 2004 General Surgery Coding Alert ("3 Questions You Must Ask Yourself When Coding... Read more
Reader Questions:
Forgo -57 for Patients Headed Directly to OR
Question: When should I use modifier -57 (Decision for surgery)? Does this modifier apply ... Read more
Reader Questions:
Medicare Provides Free Access to NCCI Edits
Question: I heard that Medicare posted the National Correct Coding Initiative (NCCI) edits... Read more
Reader Questions:
Same-Day Discharge? Report 99234 Series
Question: We kept a patient in the hospital overnight for observation and decided the next... Read more
Reader Questions:
New Medical Record Doesn't Mean New Patient
Question: When a patient presents to the office for the first time after one of our surgeo... Read more
Reader Questions:
Consider Family Consult a Patient Service
Question: A patient comes in to discuss the care of his wife, who is also a patient and wh... Read more
Reader Questions:
Use V Codes for OSHA-Required Tests
Question: After performing a blood draw, a nurse in our private surgical practice accident... Read more
You Be the Coder:
CPT Now Provides a Code for M2A Capsule
Question: Our office just purchased equipment so we can conduct in-office M2A Capsule test... Read more
Want to Make the Most of Your Lap Chole Claims? 4 Steps Show You How
Read the operative note carefully and apply modifier -22 when justified If you're... Read more
OIG Alert:
Make Sure That Consult Isn't a Transfer of Care (or Vice Versa)
To avoid being caught up in an OIG investigation, be sure that a visit meets all the consu... Read more
Consult or Not? Take Our Quiz and Test Your Savvy
You must have the 'three R's' to report a consultTo test your knowledge of what separates ... Read more
Don't Risk Losing Thousands on Subsequent Hospital Care
Strengthen documentation to improve your E/M claimsAre you worried that your surgeon is do... Read more
Reader Questions:
Claim Appendectomy, Bariatric Surgery Separately
Question: While performing gastroenterostomy, the surgeon also removed the patient's appen... Read more
Reader Questions:
For Most Payers, You No Longer Need -51
Question: I noticed that CPT includes modifier -51 for "multiple procedures." I never appe... Read more
Reader Questions:
Skip Anesthesia Codes for Conscious Sedation
Question: Especially when dealing with young children, our surgeon will administer conscio... Read more
Reader Questions:
Secondary Closure? Choose 12020/13160
Question: What is the proper code to describe secondary closure of abdominal wall dehiscen... Read more
You Be the Coder:
Thrombectomy and Artery Repair Go Together
Question: The surgeon performed a repair of a pseudoaneurysm of the right iliac artery usi... Read more
Is the Subclavian a 2nd-Order or a 3rd-Order Vessel? Take a Crash Course in Branch Coding
Report catheter placement according to location and vessel In general surgery practice, ca... Read more
6 Points Every Coder Must Know About NCCI
Learn when it's OK to unbundle and increase your reimbursement potential If you're reporti... Read more
Coding Tips:
4 Steps to Correct Arterial Coding
If you want to decrease your chances of losing deserved reimbursement for arterial cathete... Read more
Prepare Now for a New Diagnosis for Stroke and CVA
Payers are already gearing up to require 434.91 Come Oct. 1, you're going to have to apply... Read more
Reporting Related Codes? Use Modifiers -59 And -51 to Keep Claims Clear
Modifier -59 is for procedures you would not normally report together When a patient requi... Read more
YOU BE THE EXPERT:
Are Dilations and Ablations Separately Reportable?
  Question: The ob-gyn performed endometrial ablation on a patient after performing c... Read more
Reader Question:
Don't Let Patient's Age Drive Diabetes Diagnosis
Question: The surgeon recently saw a 16-year-old patient with underlying diabetes. We wer... Read more
Reader Question:
Treat 'Lap-Assisted' Colectomy as Open
Question: What is the appropriate code for a "lap-assisted" colectomy? The surgeon makes ... Read more
Reader Question:
Here's How to Appeal Modifier -25 Denials
Question: Whenever I use modifier -25 on an E/M service with a procedure code on the same... Read more
Reader Question:
Code Carefully, Negotiate to Offset Botox Costs
Question: Recently, our cost for Botox has increased to $448 per vial (plus tax), while r... Read more
Reader Question:
Report Layered Closure Separately
Question: Our surgeon saw a patient with lesions on his face and cheek. He excised a 2.6-... Read more
Reader Question:
GI Bleed Can Mean a 2-Code Colonoscopy Claim
Question: Our surgeon performed a colonoscopy, during which he removed a polyp using the ... Read more
Reader Question:
You Should Report 19102 Once per Lesion
Question: The surgeon performed an ultrasound-guided biopsy of a mass in the patient's le... Read more
Reader Question:
Look for Signs of Abuse
  Question: What are some of the signs of physical, sexual and/or emotional abuse in ... Read more
Reader Question:
Check CPT for Modifier -51 Exemptions
  Question: Do I have to use modifier -51 every time I code a visit in which the inte... Read more
You Be the Coder:
Include Control of Bleeding in Primary Procedure
Question: During bowel resection, our surgeon dictated that she performed "control of ble... Read more
New Diagnoses for Decubitus Ulcers Should Help Reduce Denials
Site-specific ICD-9 codes will increase your options when describing multiple ulcers Gener... Read more
Biopsy and Excision at the Same Time? Think Again
Reserve 11100/11101 for pathology specimens only If you're reporting biopsy codes 11100 an... Read more
Are You Reporting Reduced Services Correctly?
Knowing why the physician halted the procedure matters for modifiers -52/-53 When a surgeo... Read more
If You're Cutting Fees for -52 And -53, You're Losing Out
If you're appending modifier -52 or -53 to a claim, you want to tell the payer why. Includ... Read more
Our Experts Respond:
What Makes a Postoperative Complication 'Unrelated'?
When deciding whether you should separately report postoperative wound care during the glo... Read more
Reader Question:
Selecting 99291 Means Better Reimbursement
Question: Are there any advantages to choosing critical care codes rather than high-payin... Read more
Reader Question:
No More Starred Procedures Means More Modifiers
Question: What's the practical significance of losing the "starred designation" in CPT 20... Read more
Reader Question:
Check Report Before Selecting Benign or Malignant
Question: When coding removal of a skin lesion, how do I know if I should select the beni... Read more
Reader Question:
Documentation Should Guide Modifier -22 Use
Question: Our surgeon performed a laparoscopic cholecystectomy with an attempted intraope... Read more
You Be the Coder:
Do Consults Have Time Limits?
Question: If I perform an office consultation on a patient, how much time must elapse bef... Read more
Debunk the 99211 Myth - It's Not Just for Nurses
If a visit warrants 99211, you can recoup an additional $20 or more You can report 99211 w... Read more
Correction:
Multiple Polyp Removal
The June 2004 (Vol. 6, No. 6) General Surgery Coding Alert contained a typographical error... Read more
Earning $75-$100 per Hospital Discharge Is as Easy as A, B, C
Don't let poor documentation sink your 99238/99239 claims You needn't give up the $75 to $... Read more
Reader Question:
Use 99201-99205 if Patient Switches to Your Office
Question: When my surgeon covers for another local private-practice physician, I code the ... Read more
Reader Question:
Sedation Codes Depend on Carrier
Question: A patient with severe upper abdominal pain reported to the office for an endosco... Read more
Reader Question:
Avoid Confusing NOS and NEC
Question: What do "NEC" and "NOS" mean in diagnosis coding? How should I choose between th... Read more
Reader Question:
Bill a Single Visit for Multiple Problems
Question: The surgeon saw a patient as a follow-up for a workers' compensation claim (burn... Read more
Reader Question:
Patient's Status Drives Component E/M Coding
Question: During an office visit, our surgeon performed an expanded problem-focused histor... Read more
Reader Question:
Get Creative, and You May Get Paid for India ink
Question: A patient reported to the office for a colonoscopy, during which the surgeon use... Read more
You Be The Coder:
Which Code Describes J-P Drain?
Question: Several months following partial mastectomy, the surgeon inserted a J-P drain fo... Read more
3 Tips to Cinch Your Colonoscopy Coding
Don't let inappropriate bundles cost you $500 or more You have to consider many factors w... Read more
Earn an Additional $120 for Extended E/M Services
Prolonged services codes can get you paid for extra time spent face-to-face If you find yo... Read more
Prolonged Services Codes
+99354 - Prolonged physician service in the office or other outpatient setting requiring ... Read more
How to Choose Between Time-Based E/M, Prolonged Service
Start with history, exam and MDM Your general surgeon conducts a 50-minute established out... Read more
Get ABNs, or Risk Picking Up Patient Tabs
Without ABNs, unpaid Medicare bills may become your problem If you aren't obtaining advanc... Read more
ABNs:
What to Change, What to Leave Alone
Got an itch to make a switch on an ABN? Proceed with caution When it comes to manipulating... Read more
You Be The Expert:
ABNs and Uncovered Medicare Services
Question: Our office obtains advance beneficiary notices each time there is some doubt abo... Read more
Reader Question:
Don't Expect Payment if Patient Isn't Present
Question: Can we bill an office visit (99211-99215) for a consult with a family member to ... Read more
Reader Question:
Report 45381 for Colon Tattooing
Question: How can I code for colonoscopy with tattooing using India ink?Arkansas Subscribe... Read more
Reader Question:
Fee Schedule Can Give You Global Period Info
Question: How can I find the length of postoperative global periods for various procedures... Read more
Reader Question:
Unlisted-Procedure Code Describes Vein Excision
Question: Which code is appropriate to report excision of an infected vein?California Subs... Read more
Reader Question:
Reserve After-Hours Codes for Emergencies
Question: Recently we've had an unexpected patient load and were thinking of offering exte... Read more
Reader Question:
Report Initial Inpatient Consults for Nursing Homes
Question: Which codes should I use when the physician is called into the nursing home for ... Read more
Reader Question:
Follow the CMS Definition of 'Deliver'
Question: Since the purpose of an ABN is to inform the patient about a service, our office... Read more
You Be The Coder:
Reporting Caths as Distinct Procedures
Question: Recently, some insurance companies have bundled bilateral selective renal arteri... Read more
2 Questions to Ask Yourself When Reporting Postoperative Infections
If you're treating Medicare and private-payer claims the same, you could forfeit $80... Read more
Use Our Flow Chart to Simplify Your Post-Op Infection Coding
When surgeons treat postoperative infections during global periods, you should ask the fol... Read more
4 Pointers Make 'Add-On' Codes Easy
Don't accept payment reductions, or you could lose up to 50% on every claimWhen you report... Read more
Correction:
Screening Colonoscopy Diagnoses
A reader question of the April 2004 General Surgery Coding Alert ("Diagnosis Matters for S... Read more
3 Steps for Co-Surgery Can Mean the Difference Between 62.5% Payment and Nothing
Successful claims require modifier -62 and physician-to-physician cooperation When reporti... Read more
Here's How to Avoid the Modifier -62/Modifier -80 Mix-Up
When trying to decide between modifiers -62 and -80, the most important question to ask yo... Read more
Reader Question:
Don't Assume 'Benign' or 'Malignant'
Question: Our surgeon frequently works with diabetic and stroke patients, and I understand... Read more
Reader Question:
Rely on Outpatient Codes for ED Visits
Question: Our surgeon was recently on-call for the emergency department (ED). The ED physi... Read more
Reader Question:
Don't Report Open and Laparoscopic Codes Together
Question: If CPT does not contain a code for a specific laparoscopic procedure, how should... Read more
Reader Question:
Parastomal Repair Code Depends on Stoma Revision
Question: Which code is appropriate to report parastomal hernia repair?California Subscrib... Read more
You Be The Coder:
Report 46924 Only Once per Session
Question: When reporting destruction of lesions on the anus, may I code 46924 for each les... Read more
3 Field-Tested Tips Improve Your 'Unlisted-Procedure' Claims
Receiving fair reimbursement requires adequate preparation and documentation If you've eve... Read more
How to Use Modifier -25 for Same-Day Procedure and E/M
4 steps put you on the path to better reimbursementModifier -25 can be your best friend wh... Read more
Don't Give Up on Noncovered Procedures
Proper modifiers and a signed ABN allow you to collect paymentIf you don't want to get cau... Read more
Learn the ABCs of ABNs
An advance beneficiary notice (ABN) is a written notice to a Medicare beneficiary that Med... Read more
Restructure Appeals With These 6 Steps
Get organized for easier, more productive appeals When your practice receives a denia... Read more
Read EOBs Before Responding to Denials
What 'noncovered service' really means to your office You can't streamlin... Read more
You Be The Expert:
What Makes a Clean Claim?
Question: We are having problems in our general surgery practice with the number of clai... Read more
Reader Question:
Report 92950 for Resuscitation
Question: Our surgeon was making rounds at the hospital today when he responded to a "STAT... Read more
Reader Question:
For Thrombectomy After Fistula, Append -79
Question: The surgeon created an AV fistula in a renal-failure patient. Within a week, the... Read more
Reader Question:
Diagnosis Matters for Screening Colonoscopy
Question: We recently filed a claim for a screening colonoscopy for a Medicare patient, bu... Read more
Reader Question:
Co-Management May Warrant Consult
Question: Can I report a consultation if the surgeon helps to co-manage a patient's care?S... Read more
Reader Question:
Bridge the Communication Gap ASAP
Question: The physicians and billers in my office don't practice open communication, and i... Read more
You Be The Coder:
Can 'New' and 'Established' Affect Consults?
Question: May I bill a consult for an established patient (last seen two years ago) seen b... Read more
You Be The Coder:
Can 'New' and 'Established' Affect Consults?
Question: May I bill a consult for an established patient (last seen two years ago) seen b... Read more
4 Tips Help You Master the 'Multiple Scope' Rule
Use caution for scopes in the same family, experts say When your surgeon performs seve... Read more
Identify Critical Care and Receive a Vital Payment Boost
Do you get nervous when claiming critical care? If so, you're not alone. But if you c... Read more
Quick Quiz:
Critical Care
No one wants to go to the trouble of filing a critical care claim only to have it rejected... Read more
3 Strategies Guide Your 'Late Effects' Coding
  Don't confuse late effects with complications: The two are not the same. &qu... Read more
Reader Question:
Report 99255 Just Once Daily
Question: If I report 99255 more than once for the same patient on different days, Medicar... Read more
Reader Question:
Choose 35301 for Endarterectomy
Question: What are the proper codes for carotid endarterectomy? Washington, D.C., Subscrib... Read more
Reader Question:
Include Catheter Maintenance in E/M
Question: How can I report catheter maintenance following venous access procedures? I've c... Read more
Reader Question:
For Adhesive Strips Alone, Use E/M
Question: Recently, a payer rejected a claim for wound repair (12005) using a combination ... Read more
You Be the Coder:
Is Biopsy Included in Lobectomy?
Question: The surgeon took a wedge biopsy of the lung and sent it to pathology. The biopsy... Read more
Are You Getting All the Payment You've Earned for Cholecystectomy?
Hint: Check for complications, open procedures Although reporting cholecystectomy is usua... Read more
An ED Visit and Admission on the Same Day? Here's How
How can you code for optimal reimbursement if the surgeon sees a patient in the emergency ... Read more
Fee Schedule Update:
Higher Payments Will Boost Your Bottom Line
Once again for 2004, Congress has passed legislation that reverses a threatened reduction ... Read more
If You Haven't Gone Electronic, Now's the Time
CMS final rule mandates e-claims Are you submitting Medicare claims electronically? If not... Read more
Correction
The January issue of General Surgery Coding Alert ("Have Skin Grafts Got You Guessing?" p.... Read more
Reader Question:
Bill On-Call Visits as 'Established'
Question: Our physician is "on-call" for another surgeon. If he sees one of the surgeon's ... Read more
Reader Question:
Same-Day Observation/Discharge = 99234-99236
Question: A patient presented to the ED complaining of dizziness and nausea following a mi... Read more
Reader Question:
Use Split-Thickness Codes for Keratinocytes
Question: How should I code for harvesting of keratinocytes for skin grafts?Texas Subscrib... Read more
Reader Question:
G-Tube Is a 'Separate' Procedure
Question: The surgeon performed both large (44140) and small (44120) bowel resection and p... Read more
Reader Question:
Medicare Won't Recognize 'After Hours'
Question: A Medicare patient knocked on the door on a Friday when the office was closed. H... Read more
Reader Question:
Select 99220 and 99217 for Multiday Observation
Question: Our surgeon treated a patient in the emergency department, and he admitted the p... Read more
Reader Question:
Report Initial Hospital Care for Admits Only
Question: I was recently called into the hospital to take over the care of a patient whe... Read more
Reader Question:
Three Steps for Excision/Biopsy Coding
Question: Our surgeon obtained a partial incisional biopsy followed by excision of the sam... Read more
You Be the Coder:
Modifier -22 or Unlisted-Procedure Code?
Question: Our surgeon asks us to report procedures that take extra time and effort with an... Read more
Have Skin Grafts Got You Guessing?
Use our 4-step method to select the right code What's your method for choosing among the ... Read more
Avoid OIG Scrutiny
Shore up diagnostic test, modifier -59 claims in 2004 What could be more frustrating than ... Read more
Correction:
Full- Versus Split-Thickness Graft
An example in the December 2003 General Surgery Coding Alert ("Are You Reporting 16000-160... Read more
Get the Scoop on CPT's New Catheter/Line Placement Codes
General surgery coders, rejoice: For 2004, CPT completely revamps the catheter and line pl... Read more
No Stars to Guide You in 2004? Here's What to Do
You may need to change the way you report starred procedures to private payers beginning J... Read more
Less Biopsy Confusion in 2004
Bill separately only if it's a different lesion or different site For 2004, CPT has slight... Read more
News You Can Use:
CMS Makes It Easier (and Cheaper) to Get NCCI
Tired of shelling out hundreds of dollars a year to stay current on the National Correct C... Read more
Reader Question:
Observe Fascial Layer for Superficial Versus Deep
Question: How can I distinguish between superficial (38500) and deep (38525) lymph node bi... Read more
Reader Question:
Choose 76000 for Catheter Placement
Question: What is the correct fluoroscopy code for catheter placement - 76000 or 76003? Il... Read more
Reader Question:
Reason for Stopping Differentiates -52 and -53
Question: If one of our surgeons stops in the middle of diagnostic testing, or even a mino... Read more
You Be the Coder:
Control of Bleeding With Surgical Procedures
Question: When can we report the control of bleeding separately, such as during colonoscop... Read more
Available Years:  2004  2003  2002  2001  2000  1999