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General Surgery Coding Alert

Either Debridement or Excision Is Possible for Decubitus Ulcers:
Here's How to Choose
Muscle flaps and skin grafts for closure can be separate When reporting treatment for... Read more
Coding 101:
Don't Jump the Gun on Diagnosis Coding
Medical necessity is not necessarily top priority If your diagnosis coding fails to s... Read more
News in Brief:
Medicare Payments Set to Dive -- but There's Hope
Bad news: Brace yourself for the possibility of lower Medicare payments -- all physician... Read more
Reader Questions:
Treatment, Tests Don't Rule Out a Consult
Question: Can I still report a consultation code if the "consulting" physician initiates... Read more
Reader Questions:
Turn to Modifiers for Bilateral Breast Injection
Question: When the physician performs four injections in the left breast for one sentine... Read more
Reader Questions:
Locum Tenens Solutions in 3 Steps
Question: One of our physicians will be out of the office for an extended period, and a ... Read more
Reader Questions:
Cut Out the Guesswork in Lesion Excision Coding
Question: We-re confused about how to figure out the margin size when the physician exci... Read more
Reader Questions:
Separate Critical Care Claims Could Lead to Denials
Question: Can two physicians claim critical care for the same patient? I can find nothin... Read more
You Be the Coder:
How Do You Capture a STARR?
Question: Our surgeon has recently begun to perform the STARR procedure, and I am unsure... Read more
4 Steps Help You Get Critical Care Right
Evidence of patient's critical status is absolutely required To determine if your sur... Read more
New Lymphoma Codes Top 2008 ICD-9 Changes
You-ll continue to rely on 202.8x for unspecified conditions Upcoming changes for the 2... Read more
Reader Questions:
Include I&D in Excision
Question: Prior to excision, the surgeon had to incise and drain a pilonidal cyst. May w... Read more
Reader Questions:
Separate Diagnoses Don't Guarantee Modifier 59
Question: One of the coders in our department insists that we can use modifier 59 if the... Read more
Reader Questions:
Pseudoaneurysm Is Still an Aneurysm
Question: My surgeon documented a "pseudo-aneurysm." What is it, and what diagnosis code... Read more
Reader Questions:
Avoid the Level-3 E/M Rut
Question: I think my surgeons frequently perform office visits that warrant coding at leve... Read more
Reader Questions:
Unbundle Biopsy, Destruction With Modifier 59
Question: The surgeon takes a biopsy of a left elbow lesion and, at the same time and at... Read more
You Be the Coder:
Are 2nd- and 3rd-Order Caths Separate?
Question: My surgeon performed a catheterization of the right vertebral (third order) an... Read more
Capture Associated Procedures for Complete Endovascular AAA Repair Coding
Report prosthesis insertion by site of introduction When picking your way through an end... Read more
Stop Drug Waste From Shrinking Your Bottom Line
You can gain payment even for unused Botox units Botox is expensive, and if you-re not bi... Read more
ICD-9 Lesion Coding:
Why Patience Pays
The info you need is in the pathology report, not necessarily encounter notes When assign... Read more
Clip & Save ~ Simplify Your Place-of-Service Coding With This List
Fingertip guide to your most common POS eliminates confusion Choosing the correct place-o... Read more
Reader Question ~ Skin Graft Is More Than Suturing
Question: The patient sliced the tip of his finger trying to catch a piece of falling meta... Read more
Reader Question ~ Separate Documentation Keys Modifier 25 Coding
Question: I am having trouble with my modifier 25 coding, specifically with my documentati... Read more
Reader Question ~ Mesh Add-on Can't Stand Alone
Question: We-ve had a rash of infected mesh cases recently, and our physicians want to rep... Read more
Reader Question ~ Biopsy and Excision Can Be Separate
Question: What is the proper coding if my surgeon takes a biopsy and sends it to pathology... Read more
You Be the Coder ~ Is Gastric Band Removal Separate With Bypass?
Question: The patient underwent gastric bypass (43644) with removal of gastric band and su... Read more
Technology Review Allows You to Report Endovascular AAA Repairs With Ease
Manufacturers may make several type of prostheses, so rely on details, not trade names, ... Read more
Don't Access Endo Codes for Open Repairs
Not all patients are candidates for endovascular AAA repair. Traditionally, graft repair o... Read more
Consult Confusion Will Continue Into Next Year
Agonizing audits may settle the issue What's the difference between a consult and a trans... Read more
Subscriber Bonus ~ Accomplish Your CEU Goals Using Publications You Already Receive
If you-re a Certified Professional Coder (CPC) through the American Academy of Professiona... Read more
Reader Question ~ Consult Request Doesn't Have to Name Names
Question: How specific must a consult request be? I know there must be a specific reason f... Read more
Reader Question ~ Capture Self-Pays With NEMB
Question: I keep hearing the term -NEMB,- but I-m not exactly sure what it is. I know that... Read more
Reader Question ~ Sutures Bundle Dermabond
Question: An established Medicare patient reports to the surgeon's office after falling fr... Read more
Reader Question ~ Multiple Flaps Could Mean Appending 59
Question: The surgeon documented rotation of temporalis muscle flap, rotation of sternocle... Read more
Reader Question ~ 'One Size Fits All' Fee Schedule Isn't Required
Question: Must we bill all patients at the same rate?Pennsylvania Subscriber Answer: Tech... Read more
Reader Question ~ Infection Isn't Necessarily 'Related'
Question: Nine days after a laparoscopic cholecystectomy (90-day global), a third-party in... Read more
You Be the Coder ~ Are Same-Specialty Consults Allowed?
Question: Can physicians of the same specialty request or receive a consult from other phy... Read more
Stop Undervaluing Excisions:
Get the Facts Here
Limiting yourself to superficial excisions will hurt coding accuracy and reimbursementWhen... Read more
Integumentary Anatomy Primer
Understanding surgeon documentation and assigning the appropriate excision is easier if yo... Read more
Don't Forget S Codes for Private-Pay Lap Repairs
Medicare calls for unlisted-procedure code, but not all insurers agreeWhen reporting incis... Read more
Take Closures With Excision on a Case-by-Case Basis
Sometimes repairs are bundled, but sometimes notJust as with integumentary system excision... Read more
CCI Bundles Burn and Debridement Codes
Modifier 59 remains a possibility, but you need to know when to use itThe most recent vers... Read more
READER QUESTIONS:
Global Re-Excision Needs 58
Question: One month after a needle excision, the surgeon performs a re-excision of breast ... Read more
READER QUESTIONS:
Difficult Lap Appendectomy Calls for 22
Question: There are different codes for open appendectomy depending on whether the appendi... Read more
READER QUESTIONS:
Modifier Isn't the Issue for Wound Repair Closure
Question: When reporting a lesion excision (116xx) with a layered closure, do we have to a... Read more
READER QUESTIONS:
Consult Report Can Be Part of Shared Record
Question: Consult rules state that the consulting physician must send a written report of ... Read more
You Be the Coder:
What's the Timing for 25?
Question: The surgeon sees a patient in consult-ation for cellulitis of the arm. The next ... Read more
Lesion Excisions Don't Add Up? Here's What to Do Instead
Tip: Rules for laceration repair don't apply to excision procedures When your physician e... Read more
Know When to Treat 'Separate Procedures' Separately
Turn to NCCI for guidance if you-re in doubt about a bundle The true meaning of a -separa... Read more
Share the E/M Work, Enjoy Full E/M Payment
Physician must see the patient if there's a new problem A -shared visit- describes... Read more
Shared Visits Offer Several Advantages
You can use Medicare's shared-visit provision when your NPPs lend your physicians a helpin... Read more
Reader Questions:
Avoid Same-Time Biopsy and Excision
Question: Can we report a biopsy and excision of the same lesion during the same session? ... Read more
Reader Questions:
Burn Severity Is Important to Dx Accuracy
Question: I know that it's important to know a burn's severity when assigning a diagnosis ... Read more
Reader Questions:
Treat Foot FBRs Differently Than Soft-Tissue FBRs
Question: During an unrelated visit, the surgeon performed simple foreign-body removal (FB... Read more
Reader Questions:
1 Element Can Count Twice for E/M Status
Question: When coding E/M services, can we count the same element twice, for instance, as ... Read more
Reader Questions:
Call on Up to 8 ICD-9 Codes, When Necessary
Question: I was recently told that we can use no more than four diagnosis codes on an indi... Read more
You Be the Coder:
Where Does 'Observation' Take Place?
Question: Our surgeon performed an observation service for a patient who was not in the ob... Read more
Make the Most of VAC/VAD in 3 Easy Steps
Not all wound care codes are limited to NPPs Although negative-pressure therapy, or vac... Read more
Learn Why It's Necessary to Demonstrate Medical Necessity
History and exam alone won't sustain your claim If you are a victim of the -E/M looph... Read more
Why Modifiers 76 and 77 Matter -- Even When They Don't
Can you tell when a different modifier is a better choice? Here's how Medicare consid... Read more
News That Affects You:
2007 Conversion Factor Doesn't Budge, Payments Will
Higher E/M reimbursement leads to cuts elsewhere Congress has reversed a proposed 5 p... Read more
Reader Question:
Placing Pump Won't Pay
Question: We have just started billing for the OnQ pain pump. Medicare is denying all of... Read more
Reader Question:
Implant Removal Is Part of Excision
Question: The patient underwent a modified radical mastectomy with removal of implant ca... Read more
Reader Question:
2 Day's Observation May Not Mean 2 Codes
Question: A patient is assigned to a hospitalist group for observation admission. 'The e... Read more
Reader Question:
Rely on Unlisted -- if It's Appropriate
Question: Our surgeons are using a laparoscopic technique for incisional hernia repairs,... Read more
You Be the Coder:
How Does Depth Affect Excision Coding?
Question: The surgeon excised a lipoma from a patient's back measuring 5.0 cm x 4.0 cm x... Read more
When Wound Repair Isn't Enough, Turn to Tissue Transfers:
6 Steps Show You How
You won't report lesion excision separatelyWhen the surgeon performs adjacent tissue trans... Read more
3 Ways to Do Dx Coding Right
Signs and symptoms may sometimes be your best choiceChoosing the right CPT procedure code ... Read more
Don't Mistake 99221-99223 for Admission Codes
Case study shows you the difference between office visits and admissionsA hospital admissi... Read more
Reader Question:
Report 1 Code for Pressure Ulcer Treatment
Question: The surgeon saw a patient for treatment of a pressure ulcer on her lower back. T... Read more
Reader Question:
Carefully Choose Between Modifiers 52 and 53
Question: How should I decide between modifiers 52 and 53? For instance, what if the surge... Read more
Readers Question:
Consider More Than Layers When Reporting Wound Repair
Question: Which is the appropriate code to report repair of an irregular, 5-cm laceration ... Read more
You Be The Coder:
What's the Dx for Asymptomatic Patient?
Question: Our surgeon recently treated two patients in the emergency department (ED) who w... Read more
Perfect Your Cholecystectomy Claims:
Our Expert Advice Shows You How
Open vs. laparoscopic is one of several important factors Do you want to be sure that you... Read more
3 Rules Simplify Your E/M Claims
Rest homes require a different POS code than nursing facilities The financial health of m... Read more
Watch Out:
Pain Codes Likely Aren't What You Think
Call on a definitive dx if available You may be tempted to report several new pain codes... Read more
QUICK TIP:
'Small' Surgeries Might Lead to Bigger Payments -- Here's How
Apply modifier 63 much like 22, but not at the same time Surgical procedures on infants c... Read more
READER QUESTION:
Adjustments Aren't the Same as Revisions
Question: How should I code for adjustments my surgeon makes to a laparoscopically placed ... Read more
READER QUESTION:
Know Your Terms for Easy Neoplasm Coding
Question: I-m new to coding and unfamiliar with neoplasm terminology. Specifically, what a... Read more
READER QUESTION:
'Inpatient' Covers More Than Just Hospitals
Question: Is a nursing home an -inpatient- setting? Specifically, should I use the inpatie... Read more
READER QUESTION:
Gastric Aspiration Calls for 91105
Question: An established patient comes to the office complaining of rectal bleeding. The d... Read more
YOU BE THE CODER:
What Separates Superficial From Deep?
Question: How should I determine when to use 20200 (superficial muscle biopsy) rather than... Read more
Your Lesion Destruction Coding Gains Precision for 2007
Actinic keratosis dx gives a clue to malignant status Beginning Jan. 1, you can choose CP... Read more
CPT 2007:
Go With the Flow to Determine 'New' vs. 'Established'
Even if the patient has been to your office before, he might be new Proper coding for var... Read more
CLIP & SAVE:
Here's the Quick Way to Find Out if the Patient Is Really New
Take the AMA's advice and answer these five questions to determine definitively if you sho... Read more
CPT 2007:
What You Need to Know About the New GI Codes
Prepare for new open and laparoscopic GES codes, also CPT 2007 has deleted two codes (441... Read more
CODING QUICK UPDATE:
The 'Unlikely' Will Definitely Happen
CMS delivers on long-promised initiative Ready yourself now: Beginning in January 2007, y... Read more
Save Time and Trouble by Using ABN Correctly
Learn the basics of this common document  An advance beneficiary notice is a written... Read more
READER QUESTION:
30-Minute Minimum for Critical Care
Question: I-m confused by the time requirements for reporting critical care services (9929... Read more
READER QUESTION:
POS Gives Clue to NF Service's Codeability
Question: Our surgeon discharges a patient from the hospital and then admits him to a nurs... Read more
READER QUESTION:
Separate Payment Unlikely for Microscope
Question: Can we report 69990 for separate payment if our surgeon uses the operating micro... Read more
YOU BE THE CODER:
Can You 'Share' a Consult?
Question: I know that a nonphysician practitioner  and a surgeon can -share- an E/M v... Read more
Will New Mastectomy Codes Revolutionize Your Claims? Find Out Now
Surgeon intent still matters most for excisions CPT 2007 creates a whole new subsection d... Read more
What You Must Know About Revised Consult Guidelines
Remember: 1 consult per inpatient stay is the limit CPT 2007 has added instructional text... Read more
2007 Skin Prep Codes Could Mean More Fitting Payments
Anatomic location is now a factor for graft preparation CPT 2007 brings you four new code... Read more
READER QUESTION:
Watch Mastectomy/Lymph Excision Unbundle
Question: When the surgeon removes lymph nodes during a partial mastectomy, may we report ... Read more
READER QUESTION:
Patient-Generated Second Opinion Isn't a Consult
Question: I know that CPT deleted the confirmatory consult codes for billing second opinio... Read more
READER QUESTION ~ Check Fee Schedule for Global-Period Info
Question: I see a lot of discussion about -global periods,- but I cannot find anything in ... Read more
YOU BE THE CODER:
Do Telephone Codes Pay?
Question: I recently noticed that CPT contains E/M codes specifically for telephone servic... Read more
Available Years:  2007  2006  2005  2004  2003  2002  2001  2000  1999