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General Surgery Coding Alert

CPT® 2015:
Refine Recent Esophagoscopy Overhaul With New/Revised Codes
Use notes to clarify coding bundles, too. Hopefully you’re used to the esophagea... Read more
ICD-10:
Zenker's Diverticulum Gets Direct Crosswalk
But congenital esophageal diverticulum is different. You have a new CPT® code for ... Read more
Medicare Programs:
Avoid Penalties and Bring Home PQRS Pay
Get on EHR bandwagon, too. The cost of ignoring Medicare incentives keeps going up, so... Read more
Global Surgical Package:
See What All '0s' Might Mean for Your Surgery Practice
Don’t increase your follow-up care. You’ve seen CMS’s proposal to el... Read more
Reader Question:
Follow Guidelines to Master This Vascular Case
Question: Our surgeon performed an atherectomy in the posterior tibial artery and t... Read more
Reader Question:
Focus Breast Biopsy Codes
Question: Which CPT® codes distinguish between needle-core versus rotating biop... Read more
Reader Question:
19304 Focus is Skin Sparing
Question: I’ve heard that the distinguishing difference between 19303 and 193... Read more
You Be the Coder:
Separate Session Warrants Separate Code
Question: Our surgeon biopsied a suspicious bleeding lesion during an anoscopy proc... Read more
CPT® 2015:
Investigate Your Chronic Care Management Options
Watch for deleted ‘face-to-face’ requirement. With clearer guidelines for ... Read more
CCI 20.3:
Expect Contrast Bundles With No Way Out
Include venous access, radiology in many procedures. You’re facing the last annu... Read more
ICD-10:
Expand Ulcerative Colitis Options Next Year
Location isn’t all you need to know. Make room for complications when reporti... Read more
Practice Management:
Avoid Brutal HIPAA Fines With These 3 Steps
Take HITECH lessons to heart and protect your bottom line.  They might look like ... Read more
Reader Question:
Stick To Pathology Dx for ICD-9 Choice
Question: We received a pathology report on a breast case that stated, “lobul... Read more
Reader Question:
Pick Best Modifier for Return to Surgery
Question: A Medicare patient returned to the endoscopy lab to control a bleeding po... Read more
Reader Question:
Account for Additional Lap Chole Work
Question: Our general surgeon performed a laparoscopic cholecystectomy with cholang... Read more
You Be the Coder:
Devil is in the Details for Port Placement Codes
Question: When our surgeon places a port for chemotherapy access, which procedure c... Read more
CPT® 2015:
Jumpstart Your General Surgery Coding for Next Year
Expect systematic digestive tract changes. Forewarned is forearmed, so let us take you... Read more
CPT® Errata:
Fine Tune Vascular and Laparoscopic Coding With These Updates
Don’t miss changes to FEVAR and more. The coding world seems in a rush to tackle... Read more
ICD-10:
938 to T18.9 Adds Encounter Detail
Foreign body coding gets specific. When your surgeon removes a foreign body from th... Read more
Reader Question:
Bring In ABN Benefits
Question: Should I bill Medicare for services that I know they’ll deny based ... Read more
Reader Question:
Don't Make This $104 Mistake
Question: Our surgeon removed a mass from a patient’s nose (1.3 cm, including... Read more
Reader Question:
Duodenojejunostomy Depends on Approach
Question: I’m not familiar with this term and don’t know how to report ... Read more
You Be the Coder:
Beware Thyroid FNA and Needle Biopsy Together
Question: For a thyroid case, the op report shows that the surgeon performed a fine... Read more
CMS Payment Policies:
Look For Proposed Global Period Overhaul
You could charge separate E/M, in many cases. A big surprise hit the presses in the Ju... Read more
ICD-10:
174.8 Yields More Specific Crosswalks
Change how you report ectopic sites. Other specified sites” won’t be a ... Read more
Vascular Surgery:
Decode Intravascular Stent Coding Restrictions
Follow CCI changes that tell the tale.  When your general surgeon places an intra... Read more
ICD-10:
Check Out These CMS Testing Stats at Last
Look ahead to more testing opportunities. Following the ICD-10 implementation delay an... Read more
Diagnosis Codes:
Expect Limited Updates to Both Code Sets
Delay doesn’t extend the freeze. Even though Medicare extended the deadline to con... Read more
Reader Question:
Unravel UB-04 and CMS-1500 Differences
Question: I recently switched from billing for hospital outpatient surgeries to cod... Read more
Reader Question:
Single Mesh Means Single Code
Question: The surgeon performed a laparoscopic inguinal hernia repair (left side), ... Read more
Reader Question:
Focus on Digit Modifiers
Question: Our surgeon excised masses in three different areas: one deep in the righ... Read more
Reader Question:
Avoid C9733 for Physician Billing
Question: During a laparoscopic cholecystectomy, our surgeon performs an injection ... Read more
You Be the Coder:
Don't Forget Surgical Approach Documentation
Question: A patient had a malignant neoplasm of abdomen with obstruction and recurr... Read more
CCI 20.2:
Resist Separate Vessel Repair With Many Surgeries
Forsake separate assessment and management, too. Sometimes you’ll see a lull in ... Read more
ICD-10:
216 Splits to D22 and D23 for Benign Skin Lesions
Look for 5th digit too. All you need to know right now to report a nevus or other n... Read more
Modifiers:
Read This if Your Surgeons Ever Divvy Up Care
Identify different services within the global period. If you skip the modifier when yo... Read more
EHR:
Relax Your Race for Meaningful Use Compliance
Check out this CMS deadline proposal. If you’re not on schedule to comply with t... Read more
Reader Question:
Provide Details for Rectal Ulcer Case
Question: I have a surgical note that states the surgeon did an “over-sewing&... Read more
Reader Question:
Decode ICD-10 Differences
Question: I appreciate the monthly ICD-10 example in your newsletter, but I don&rsq... Read more
Reader Question:
Define Salivary Biopsy Type
Question: Our surgeon performed a salivary gland biopsy from the left and right. Wh... Read more
You Be the Coder:
Identify Same or Different Incision for Bone Marrow Coding
Question: When our surgeon performs a bone marrow aspiration and biopsy for a Medic... Read more
Case Study:
Do This When Diagnostic Colonoscopy Turns to Treatment
Look for relation to splenic flexure. You read about screening colonoscopies last mont... Read more
Hemorrhoids:
Selecting the Wrong Internal Procedure Code Could Cost You $255
One note allows mixed codes for internal procedures. A quick glance at the CPT® &l... Read more
ICD-10:
569.8 Translates to K55.2 for Angiodysplasia
Hemorrhage is still the key to code selection. Blood in the stool can lead to many ... Read more
ICD-10 Update:
See How CMS Addresses Delay
Users question ICD-9, too. You know that Congress instituted an ICD-10 delay, but do y... Read more
OIG:
Revise 'Two Midnight' Rule for Inpatient Stay
Observation may increase under current regulation. Less than a year after CMS enacted ... Read more
Reader Question:
Consider Global and Bilateral for Code Selection
Question: Two weeks following a left-breast, wire-localized lumpectomy, our surgeon... Read more
Reader Question:
Record Review Can Impact MDM
Question: A patient had 10 years of medical records sent to our surgeon for review.... Read more
Reader Question:
Select Assistant Surgery Modifier For Your Case
Question: We just received a rejection for an assistant surgeon fee for an epigastr... Read more
Reader Question:
Code This Skin Re-Excision Scenario
Question: Our surgeon removed a malignant skin lesion, which we reported with 11600... Read more
You Be the Coder:
Know When Vascular Procedure Includes Radiology
Question: Our vascular surgeon carried out an angiojet thrombectomy with multiple p... Read more
Case Study:
Payer, Risk, and Findings Drive Colonoscopy Code Choices
See how one little modifier can help. If just thinking about colonoscopy coding gives ... Read more
ICD-10:
Z12.11 Replaces V76.51 for Screening Colonoscopy
Show medical necessity for preventive service. With the recent legislative implemen... Read more
Bilateral Surgery:
4 Tips Help You Capture 'Both Sides' Pay
Decode LT/RT, 50 modifier choices. Your general surgeon might perform procedures on a ... Read more
Modifier 24:
Reject Common Myths That Block Your Post-Op E/M Pay
Find out if you really need a new diagnosis. You don’t have to bundle every E/M ... Read more
Reader Question:
Focus on 'Incident-to' Rules
Question: The following scenario occurred in our practice: Physician A covered an e... Read more
Reader Question:
Check Distinct Procedures for Thrombectomy and Angioplasty
Question: Our vascular surgeon performed a vacuum thrombectomy with angioplasty of ... Read more
Reader Question:
Maneuver Tissue Transfer Rules
Question: When our surgeon excises a melanoma of the face and closes using adjacent... Read more
Reader Question:
Document Decision for Further Breast Surgery
Question: The surgeon performs a breast lumpectomy and the pathology findings durin... Read more
You Be the Coder:
Learn Hemorrhoid 'Combo' Codes
Question: Our surgeon treated a patient by ligating an internal hemorrhoid at left ... Read more
CCI 20.1:
Prep for 400 Esophageal Procedure Bundles
Look for more fluid collection edit pairs, too. Some specialties get a break in the se... Read more
ICD-10:
Expand 682.0 Under New Diagnosis Code Set
Pinpoint more details to choose the right code. When your general surgery practice swi... Read more
Quick Quiz:
3 Cases Hone Your 11640-11646 Skills
See if you miss extra pay opportunities. Do you know when your skin excision cases war... Read more
ICD-10 Delay:
Take At Least 1 More Year to Overhaul Dx Coding
Avoid procrastination trap. You won’t have to meet the Oct. 1, 2014 implementati... Read more
Newsbrief:
24 Percent Medicare Pay Cut Averted
Expect level pay through March 31, 2015. You’re probably used to this by now sin... Read more
Reader Question:
Surgeon Decides Separate E/M During Global
Question: Our surgeon performed an ileostomy revision, and the patient was returned... Read more
Reader Question:
Beware Fundoplication Bundles
Question: We had a case where the surgeon had to “redo” an old fundopli... Read more
Reader Question:
Use Clues to Pick Tumor Excision Code
Question: How should I code the following case? Midline incision made 7.5 cm prox... Read more
You Be the Coder:
Learn Tips for New ERCP Codes
Question: I understand that CPT® 2014 has new codes for ERCP. How should I repo... Read more
CPT® 2014:
Stents Aren't the Only ERCP Changes You Need to Know
Update your dilation and ablation codes, too. With plenty of new, deleted, and modifie... Read more
ICD-10:
Pancreatic Duct Neoplasm Has Direct Crosswalk
But watch out for overlapping sites. Moving from ICD-9 to ICD-10 shouldn’t be to... Read more
Coding Corner:
Poke Around for PNB/FNA Differences That Could Earn You $$$
Look in various sections for codes. Not all needle specimen retrievals are the same, a... Read more
Documentation:
Take 7 Steps to Ensure a Great Medical Record
Give your surgeon the right tools. If it’s not documented, it wasn’t done&... Read more
Reader Question:
See When E/M Charge Follows Surgery
Question:  When our surgeon places a peritoneal dialysis catheter in an open proced... Read more
Reader Question:
Roux-en-Y Not Limited to Obesity
Question:  How should I code a Roux-en-Y gastrojejunostomy that the surgeon perform... Read more
Reader Question:
Brush Up on Umbilical Hernia Diagnosis
Question:  What is the correct diagnosis code for an umbilical hernia with obstruct... Read more
Reader Question:
49900 Captures Abdominal Wall Repair
Question:  How should I code this case involving an injury from a motorcycle accide... Read more
Reader Question:
19301 Depends on Margins
Question:  For a patient diagnosed with breast cancer, the surgeon identified the p... Read more
You Be the Coder:
Scope Advancement Leads Code Selection
Question: During a colonoscopy, the surgeon noted “a fungating circumferentia... Read more
CCI 20.0:
Look for Fluid Collection Bundles and More
Reworked esophagoscopy codes take a hit, too. New CPT® codes might make life easie... Read more
CPT® 2014:
Clarify Who Can Provide Surgical Services
Hint: You don’t have to stay in your section of the book. If you’ve ever w... Read more
CPT® 2014:
4 Tips Update ERCP Stent Coding
Sphincterotomy no longer separate. Coding for stent placement, removal, or both via en... Read more
Medicare Pay:
3 FAQs Update Your Fee Schedule Know-How
Expect more for 2014 general surgery pay. The New Year brought some good news about th... Read more
Reader Question:
Explore Options to Enhance Patient Privacy
Question: Are there specific guidelines that our surgical group should follow to protect... Read more
Reader Question:
Distinguish 31622, 31624
Question: How should we report the following case: “Diagnostic bronchoscopy proced... Read more
You Be the Coder:
Check ICD-10 Delay Rumors
Question: I’ve heard that because Stage 2 of the Meaningful Use Requirement has be... Read more
CPT® 2014:
37241-37244: Update Your Vascular Embolization/Occlusion Coding
Drop 37204 and 37210 from your repertoire. Four new codes and an entire new introducto... Read more
ICD-10:
Prepare to Run In-Office Test
Mark your calendars for ICD-10 dry-run. Even if you think your general surgery practic... Read more
CPT® 2014:
10030 Leads Fluid-Collection Updates
Use different codes for visceral, peritoneal, other sites. With four new and two delet... Read more
CPT® 2014:
Don't Miss Repair and Biological Implant Revisions
13150 and 15777 changes need your attention. Although they may pale by comparison to t... Read more
Reader Question:
Use 'Change' Code for Gastrostomy Tube
Question: A patient presented with a partially dislocated gastrostomy tube with pain at ... Read more
Reader Question:
Place of Service Guides Modifier Choice
Question: A patient with interstitial lung disease reported for a bronchial alveolar lav... Read more
Reader Question:
Total Lobectomy Follows Hemithyroidectomy
Question: A patient had a right hemithyroidectomy 2 years ago, but our surgeon claims on... Read more
You Be the Coder:
Employ These Tools for High-Risk Screening
Question: We had a patient who underwent a “high risk” colonoscopy screening... Read more
CPT® 2014:
34841-34848: Some AAA Repair s Get FEVAR Make-Over
Look for move from Category III to Category I. You can ditch 0078T-+0081T beginning Ja... Read more
Glossary:
Decode FEVAR Procedures With These Terms
Your surgeons’ op reports might use a variety of terms for abdominal aortic aneury... Read more
ICD-10:
441.4 to 171.4: Expect Smooth AAA Diagnosis Code Transition
Understand diaphragm dividing line. The code numbers may change, but the distinguishin... Read more
CPT® 2014:
Consider Malignant Tumor Origin for Radical Resection Codes
24 revised codes single out sarcoma. When your surgeon performs a radical resection to... Read more
TCM Update:
CPT® 2014 Clarifies Transitional Care Management E/M Codes
You can use the codes for new patients, too. You’ve had a year to use CPT® 2... Read more
Reader Question:
Choose 'Pexy' Over 'Ectomy'
Question: I have a surgical note that states that the surgeon “stapled prolapsed i... Read more
Reader Question:
Define Date for Global Package
Question: The CPT® surgery guidelines state that the surgical package includes &ldqu... Read more
Reader Question:
Code Service Beyond ERCP
Question: How should we report an ERCP when the surgeon extracts a gallstone and perform... Read more
Reader Question:
Choose Nasal Code Over Skin
Question: The surgeon excised a 1.8 mm warty papilloma in the left nares on the lateral ... Read more
Reader Question:
Don't Pigeon Hole E/M Services
Question: We recently finished our first internal audit and found a potential issue: One... Read more
You Be the Coder:
Arm Isn't Only Access Graft Location
Question: What is a code for a dialysis access graft placement in the leg? The procedure... Read more
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