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General Surgery Coding Alert
General Surgery Coding Alert
General Surgery Coding Alert - 2015; Volume 17, Number 12
ICD-10:
Perfect Your ICD-10 Claims With These 3 Tips
Hint: Don’t rely on GEMs. Maybe you’re still struggling with your transiti...
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Medicare Physician Fee Schedule:
Get These Updates to Global Surgical Package and Incident-To Billing
Fees and compliance issues lead surgeons’ concerns. First, the good news —...
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HIPAA Compliance:
Get Ahead of Notification Curve for PHI Breach
Avoid stiff penalties that could hurt your practice. With fines ranging from ...
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Reader Question:
Fulfill Critical Care Criteria to Use Codes
Question:One of the surgeons in our practice thinks that when he rounds on a patient in ...
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Reader Question:
Pinpoint POS Codes with This Quick Guide
Question: I have heard that MACs are paying close attention to our place of service...
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Reader Question:
Select Modifier for Incomplete ERCP
Question: During an ERCP procedure, the surgeon made numerous failed attempts with ...
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You Be the Coder:
Earn $139 With Accurate Lesion Measure
Question: One of our surgeons reports malignant lesion excision by stating the dime...
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General Surgery Coding Alert - 2015; Volume 17, Number 11
CPT® 2016:
Rev Up Your General Surgery Coding for Next Year
Anticipate changes for cholangiography and billiary drainage. Ignorance isn’t bl...
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Clip and Save:
CPT® 2016 Surgery Code Overview
Keep this chart for reference in the New Year. We’ve gathered the new, revised, ...
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ICD-10:
Understand Grace Period
Check out these resources, too. You’re using ICD-10, and you’re not too su...
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CPT® 2016:
Get Ready for 2 New Prolonged Services Codes
And make sure to update 2 more. General surgeons may not be the best about keeping on ...
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Reader Question:
Let Tumor Type Lead Code Choice
Question: We had a case involving a melanoma re-excision of 11 cm by 3.3 cm (excise...
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Reader Question:
Seek Margin Documentation for Lumpectomy
Question: Our surgeon excised breast tissue in a procedure he described as a &ldquo...
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Reader Question:
Don't Forget Angioplasty Guidance
Question: What is the correct way to code one angioplasty in the femoral artery and...
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You Be the Coder:
Beware Medical Records Rules
Question: We discharged a patient due to non-payment, and one week later a new surg...
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General Surgery Coding Alert - 2015; Volume 17, Number 10
CPT® 2016:
Meet Proposed Changes for Larynx Codes and More
Look to vascular codes, too. The final touches on CPT® 2016 are underway, and we h...
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ICD-10:
Update Laryngeal Cancer Coding This Fall
Change ‘other’ to ‘overlapping. Not much changes but the code number...
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Billing:
Grasp 'Incident-to' Opportunity for NPP Pay
No dice for new patient or plan. If you have non-physician practitioners (NPPs) workin...
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Physician Fee Schedule:
Get to Know Proposed 'Incident-to' Changes
Just one physician will do. You just honed your “incident-to” coding skill...
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Reader Question:
Use 'G' Code for Medicare Closure
Question: We have one surgeon who likes to use tissue adhesive instead of placing a...
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Reader Question:
Distinguish Chronic, Acute in Medical Record
Question: Does ICD-9 have a default way to code acute versus chronic if the medical...
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Reader Question:
Outline Consultation Requirements
Question: Other physicians often ask surgeons in our practice for a consultation on...
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Reader Question:
Use "Other" ICD-10 Codes With Caution
Question: If I find that a common ICD-9 code that I use doesn’t have a direct...
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You Be the Coder:
Detail Maloney Bougie Dilator
Question: Our surgeon performed an esophagoscopy on a Medicare patient before the i...
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General Surgery Coding Alert - 2015; Volume 17, Number 9
EVAT Case Study:
Missed Method and Site Could Cost Your Surgeon $600+
Coding by access site is key. If your general surgeon performs vascular procedures, s...
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ICD-10:
Location, Complications Expand Varicose Vein Options
Tell your surgeons to give more specific documentation. When you report lower-extre...
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ICD-10 Update:
You Might Avoid Claims Denials in the Implementation Year
Get to the right code family. You won’t be able to keep using ICD-9 beginning Oc...
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Focus on Diagnosis:
4 Tips Highlight ICD-10 Changes
Welcome combination codes and seventh digits. By now you should be familiar with basic...
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Reader Questions:
Deal with New Medicare 'Opt Out' Process
Question: Our surgery practice has chosen to opt out of Medicare. I heard that ther...
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Reader Questions:
Look for 'Separate Procedure' Bundles
Question: We have an op note that states that the surgeon injected air into the per...
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Reader Questions:
Express Halted Surgical Procedure Using Modifier 53
Question: Our surgeon prepped and positioned a patient for repair of a recurrent in...
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Reader Questions:
Account for Enterolysis Work
Question: The surgical note states that during a laparoscopic procedure, the surgeo...
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Reader Questions:
Compare Complex and Intermediate Closure
Question: Please help me code this note: Treated 10 cm linear laceration of right...
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You Be the Coder:
Don't Miss Combination Code
Question: The op note indicates that during a flexible sigmoidoscopy procedure, the...
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General Surgery Coding Alert - 2015; Volume 17, Number 8
Lower GI:
Generate Clean EUS Claims With This Advice
Don’t miss parallel FNA codes. When your general surgeon performs an endoscopic ...
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Diverticulitis Diagnosis:
Add Perforation and Abscess Details for ICD-10
Prepare your surgeons to add op-note detail. Whether the patient’s colon diverti...
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Diagnosis Coding:
Focus Your ICD-9 to ICD-10 Transition With 3 Tips
Prime your general surgeons for reporting laterality and other detail. Whether you&rsq...
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ICD-10 Readiness:
Conquer These Steps to Smooth Your ICD-10 Transition
Your work doesn’t end on Oct. 1. Now that you have a grasp of what to expect as ...
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Reader Questions:
Focus Cyst Coding with These Tips
Question: What is the correct diagnosis code for a sebaceous cyst of the hip/pelvic...
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Reader Questions:
Learn 4 x 4 E/M Trick
Question: What is the “4 x 4 rule” as it pertains to E/M coding? Wash...
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You Be the Coder:
Don't Miss Separate Angioplasty Opportunity
Question: What is the best way to report an angioplasty and vacuum thrombectomy of ...
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General Surgery Coding Alert - 2015; Volume 17, Number 7
Tonsils and Adenoids:
Avoid Bundling Pitfalls for Clean Tonsillectomy Claims
Take this modifier 50 tip to the bank. When billing tonsillectomy and/or adenoidectomy...
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ICD-10:
1 Code for Malignant Tonsil? - Not Any More
Don’t forget additional code. You’ve had it pretty easy up until now &mdas...
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Quality Reporting:
Ignore PQRS at Your Peril - Penalties Await
Get ready for VBPM, too. If you haven’t sorted through the quality-measure...
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PQRS:
See Which Quality Measures Apply
Check CMS’s complete list for your practice. Depending on the type of procedures...
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Reader questions:
Capture Separate E/M in Post-Op Period
Question: Our surgeon performed a rubber band ligation to treat hemorrhoids. Three ...
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Reader questions:
Do This to Secure Bluetooth Devices
Question: Our surgeons use smart phones and tablets with Bluetooth capability, and ...
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Reader questions:
Look for Separate Scope Services
Question: Our physician recently performed a colonoscopy with polypectomy and also ...
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You Be the Coder:
Exploit 'Initial Vessel' Opportunity
Question:How should I report the following procedures, which are from an antegrade appro...
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General Surgery Coding Alert - 2015; Volume 17, Number 6
Vascular Surgery:
Perfect Your IVC Filter Coding With These 3 Steps
Capture steps for insertion, repositioning, and removal. When your general surgeon man...
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ICD-10:
453.5 Crosswalks to Multiple Specific Vein Codes
Get more info to accurately report chronic DVT cases. Just one ICD-9 code tells the...
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Medicare Pay:
Usher Out SGR Formula - For Good
Expect new quality pay plan(s). You won’t ever have to cross your fingers again ...
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Modifier Update:
CMS Speaks: X{EPSU} Offers 'No Benefit' For Now
You may keep using 59 until further notice. Many surgery practices have been get...
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Reader Questions:
Distinguish Facility vs. Non-Facility Fees
Question: Can you please explain whether we should use the facility global fee or t...
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Reader Questions:
Check Stent Procedure Documentation
Question: How should I code the following open surgical case: The surgeon isolated ...
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Reader Questions:
Roundup Multiple Codes for Anal Botox
Question: Our surgeon performed Botox injections to treat anal fissures. How should...
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You Be the Coder:
Watch for Adjacent Tissue Transfer Included Services
Question: If the surgeon excises a 2 x 4 cm carcinoma of the face, and closes the e...
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General Surgery Coding Alert - 2015; Volume 17, Number 5
CPT® 2015:
Capture Cannula Services for ECMO Patients
Your surgeon may be part of the life support team. If you thought you could ignore CPT...
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ICD-10:
Expand Options for Newborn Respiratory Distress Syndrome
Fourth digit adds detail. No matter the details, you have just one code to describe...
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Medicare:
No Joke: Deal With April 1 Pay Cut
Hope for Senate action after recess. The Senate wasn’t fooling when it went on b...
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HIPAA:
Face 5 Trends That Could Impact Your Compliance in 2015
Watch out for state-law violations. Maybe you know that your general surgery pra...
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Reader Questions:
Limit Unlisted Code for Colonoscopy Through Stoma
Question: Our surgeon performed a colonoscopy through a stoma for a patient with a histo...
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Reader Questions:
Let Lap Band Component Lead Code Choice
Question: We have a surgical report that describes a laparoscopic procedure in whic...
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Reader Questions:
Note Vein and Laterality for DVT Treatment
Question: What documentation should our vascular surgeons provide for DVT diagnosis...
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You Be the Coder:
Beware Bundled EGD Services
Question: If the surgeon performs an EGD with biopsy, and documents control of blee...
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General Surgery Coding Alert - 2015; Volume 17, Number 4
CPT® 2015:
Capture the Pay You Deserve With This Roadmap for Lower GI Procedures
New definitions lead the way. If you’ve ever gotten confused about which type of...
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ICD-10:
Add Complications to Crohn's Codes
Crosswalk expands with 6th digit. Just like ICD-9, you’ll find four codes for re...
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Repair:
Simple or Intermediate: Focus Laceration Coding With 4 Tips
Extensive debridement can change everything. You may think that coding for simple or i...
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ICD-10 Prep:
Get Ready With These Testing Opportunities
Await July application deadline. Maybe you’re sure your general surgery practice...
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Reader Question:
Distinguish Excision, Destruction Procedures
Question: When I have a surgical report for removal of in situ basal cell carcinoma...
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Reader Question:
See How Single Mesh Impacts Code Choice
Question: The surgeon performed a laparoscopic inguinal hernia repair on the right ...
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Reader Question:
Don't Fear ICD-10 Transition
Question: I’ve been told that ICD-10 will be nearly impossible to use because...
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Reader Question:
Ensure Encryption to Avoid HIPAA Breach
Question: If our general surgery practice uses unencrypted email to send a report w...
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You Be the Coder:
Narrow Hernia Coding With Documented Details
Question: The surgical report documents laparoscopic repair of a reducible trocar-s...
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General Surgery Coding Alert - 2015; Volume 17, Number 3
Medicare Physician Fee Schedule:
Watch for Possible April Pay Cut
But an act of Congress can save the day. So far this year, you should be experiencing ...
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CPT® 2015:
Digest Massive Endoscopy Coding Update
Greet new families for stomal procedures. If you remember all the changes to the esoph...
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ICD-10:
Add Perforation and More to Your Diverticulosis Choices
Don’t forget bleeding indication. If your surgeon performed procedures today tha...
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Practice Management:
Use These OIG Tips to Solidify Your 2015 Compliance Plan
Follow 7 tips to meet ACA requirements. You should start the New Year right by pledgin...
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Reader Question:
Meet Criteria to Bill Consultation
Question: A new patient came to see a surgeon in our practice to discuss whether she ...
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Reader Question:
Beware IRC Global Period
Question: Our surgeon saw a patient in the office, and advised a subsequent visit t...
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Reader Question:
Distinguish Simple, Intermediate, Complex Closure
Question: The surgeon repaired an 8.3 cm gash on a patient’s chest. The wound...
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You Be the Coder:
Consider Source, Location for Removal Code Selection
Question: A patient with a prior gallstone surgery presents with a painful, fibrous...
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General Surgery Coding Alert - 2015; Volume 17, Number 2
CPT® 2015:
Squash 'Abridged Colonoscopy' Coding Debate
New ‘decision tree’ defines choices. General surgery coders have long deba...
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Physician Fee Schedule:
Greet 10 'G' Codes for Lower GI Procedures
Accommodate double standards based on payer. Maybe you’re thrilled that CPT®...
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ICD-10:
Locate Hyperplastic Polyps for ICD-10
211.3 crosswalks to more specific codes. Because they’re non-neoplastic, you&rsq...
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Modifiers:
Correctly Choose Modifier 52 or 53 -- Every Time
Unscramble ‘reduced’ and ‘discontinued’ procedures. When your ...
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Reader Question:
Expect Record Review to Be Part of Office Visit
Question: A patient had 10 years of medical records sent to our physician for revie...
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Reader Question:
Unravel Subsequent vs. Initial for Hospital E/M
Question: On a recent claim, I used a CPT® code for subsequent hospital care to...
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Reader Question:
Bleeding Drives Gastric Varices Code Choice
Question: How should I report a surgeon’s treatment of gastric or esophageal ...
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Reader Question:
Expand Keratoderma Choices in ICD-10
Question: Our surgeon excised a skin lesion which the pathology report diagnosed as...
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You Be the Coder:
Bundle Same Vascular Family and Approach
Question: Can I bill 36215 and 36216 together for a first and second order thoracic...
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General Surgery Coding Alert - 2015; Volume 17, Number 1
CPT® 2015:
37218 Adds Carotid Stent Coding Option
Bundle angioplasty and more to match code revisions. Both opportunities and restrictio...
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ICD-10:
I65.2 Expands Carotid Artery Stenosis Options With 'Right' and 'Left'
Drop 433.10 beginning Oct. 1. Carotid artery stenosis might be a common reason your ge...
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CCI Impact:
Check Your Modifier 59 Use in 2015
Get ready for 4 new X{EPSU} choices. You probably rely on modifier 59 (Distinct proced...
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Medicare Errors:
Let CERT Findings Focus E/M Claims
Avoid key documentation mistakes that cost you pay. Imagine if you lost 10 percent of...
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Reader Question:
Clarify Teaching Physician Claims
Question: Our surgeon sometimes has a resident assist in surgery at a teaching hospital....
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Reader Question:
Document Donor Site to Code Advancement Flaps
Question: Our surgeon closed a deep abdominal wall defect that was approximately 440 sq....
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Reader Question:
Add to Your ICD-10 Know-How
Question: I’ve heard that ICD-10 doesn’t have an equivalent to V codes and E...
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You Be the Coder:
See How Physicians Can Discuss PHI
Question: Our general surgeon wants to talk to another physician about a patient’s...
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