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General Surgery Coding Alert
General Surgery Coding Alert
General Surgery Coding Alert - 2018; Volume 20, Number 12
CPT® 2019:
Focus FNA Reports With New 'Guidance-Specific' Codes
Distinguish first and subsequent lesions. The two existing codes your general surgeon rel...
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Modifier Quiz:
Check Your Modifier Know-How With These 5 Scenarios
Recall X{EPSU} options. Modifiers can make or break your Medicare claims, so take this op...
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Modifier Quiz Answers:
See How Your Modifier Quiz Answers Stack Up
Forget these coding tools and lose pay. Now that you've tried your hand at coding the fiv...
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CPT® 2019:
Grab This G-Tube Replacement Opportunity
Make sure to document gastrostomy tract revision. When your general surgeon performs a co...
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Reader Question:
Honor Patient PHI Request
Question: Do you have any advice to help us protect our patients' health information, if t...
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Reader Question:
Don't Double-Dip 'Diagnostic'
Question: One of our surgeons performed a diagnostic laparoscopy with ovarian cystectomy. ...
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Reader Question:
Override CCI Edit for Separate Uterine Adnexa Sites
Question: Our surgeon laparoscopically removed the patient's right ovary and tube, but als...
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Reader Question:
Restrict Modifier GT Use
Question: I heard that there was an update about modifier GT but don't understand it. Coul...
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You Be the Coder:
Code This PTA Case
Question: For a case involving a peritonsillar abscess (PTA), the surgeon performed an inc...
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General Surgery Coding Alert - 2018; Volume 20, Number 11
CPT® 2019:
Look for PICC-Line Updates and More
Know when to bundle imaging services. The only thing constant is change — so get ready ...
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Physician Fee Schedule:
Expect Potential E/M Overhaul for 2019
Watch for possible final-rule revisions. CMS has released the proposed Medicare Physician...
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Catastrophe Claims:
Follow Special Procedure Coding Rules for Hurricane Michael Victims
Watch for Medicare waivers and modifiers. If you're a general surgery practice operating ...
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Reader Question:
Beware Procedure-Code Deletion Date
Question: We had a case that involved a procedure performed in late December that we did n...
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Reader Question:
Details Guide Esophageal Code Selection
Question: The surgeon performed an endoscopy with esophagus biopsy for a patient with a di...
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Reader Question:
Limit Table-of-Risk to One Component for MDM
Question: The surgeon performed a pre-op visit before hernia surgery, and the patient has ...
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You Be the Coder:
Calculate Diameter to Cut Skin Excision Errors
Question: In an op report for a malignant lesion excision from the patient's forearm, the ...
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General Surgery Coding Alert - 2018; Volume 20, Number 10
ICD-10-CM 2019:
Tackle New Infection, Abscess, Gallbladder Codes and More
OB infections are different. With so many new diagnosis codes that could impact your gene...
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Skin Surgery Basics:
Answer 4 Questions to Focus Skin Coding Options
Define depth for shaving codes. Maybe you can drill down to the correct procedure code fo...
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HIPAA:
Grasp Real Penalty Risk for Privacy Violations
Having a program is not enough. You might think you're safe from enforcement action if yo...
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Reader Question:
Finalize Dx from Pathology
Question: Our surgeon performed a retroperitoneal exploratory laparoscopic surgery with a ...
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Reader Question:
File Timely Claim or Lose Pay
Question: We had a problem with a claim and didn't get it filed with Medicare until over a...
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Reader Question:
Pinpoint Fluid Extraction Method
Question: The surgeon extracted a fluid sample from an ovarian cyst using ultrasound guida...
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You Be the Coder:
Distinguish MUE and PTP CCI Edits
Question: What is the difference between Medically Unlikely Edits and Mutually Exclusive E...
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General Surgery Coding Alert - 2018; Volume 20, Number 9
ICD-10-CM Update:
Embrace New Dx Coding Options for Your Surgery Practice
Don't forget ‘X' place holder. With 320 new and 170 revised diagnosis codes in ICD-10-C...
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Inpatient E/M:
3 Tips Focus Subsequent Care Coding
Avoid consultation codes for Medicare. When your surgeon provides ensuing E/M services to...
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Subsequent-Care E/M:
Avoid Surgical Conflicts with 99231-99233
Pay attention to global period. If your surgeon performs an inpatient procedure that has ...
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Reader Question:
Marshal E/M Plus Surgery Pay
Question: A patient presents to the emergency room with nausea and severe lower-right abdo...
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Reader Question:
Distinguish Anoscopy, Proctosigmoidoscopy
Question: A patient presented with frequent constipation and blood in the stool. The surge...
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Reader Question:
Use MIPS Lookup Tool for Your Reporting Requirements
Question: Our practice is transitioning to MIPS, but I'm unclear whether we should send qu...
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Reader Question:
Understand Scalp "and/or" Neck
Question: Our surgeon removed a Merkel cell carcinoma from the scalp. Should we code this ...
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You Be the Coder:
Include Excision in Z-Plasty
Question: Our surgeon performed a scar revision procedure on the patient's right forearm t...
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General Surgery Coding Alert - 2018; Volume 20, Number 8
Integumentary System:
Bungle Skin Biopsy Coding and Lose Pay
Look for site-specific codes. If you think 11100-+11101 are the only codes that describe ...
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Clip and Save:
Sacrifice Up To $97 per Lesion for 11100 Misuse
Look beyond integumentary codes. You learned in “Bungle Skin Biopsy Coding and Lose Pay...
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Remittance Advice:
Keep CARC/RARC Current to Track Payment and Denials
Update files from WPC website. Who knew that the Remittance Advice (RA) statement you rec...
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Reader Question:
Follow Tips for Record Disposal when Moving
Question: Our surgery practice is moving to a new location, and we're purging old patient ...
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Reader Question:
Use Payer Policy for Coverage Clues
Question: We recently got a denial from Aetna for an EGD procedure for a 10-year-old patie...
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Reader Question:
Grasp This: Abdominal Codes Include Enterolysis
Question: Sometimes our surgeon performs a partial colectomy, either open or laparoscopic,...
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Reader Question:
Third Time's the Charm
Question: We always try to collect copays and deductibles from patients as required by the...
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Reader Question:
HIPAA Holds After Death
Question: Do HIPAA regulations require us to maintain a patient's private health informati...
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You Be the Coder:
Avoid '10 Negative ROS' Pitfall
Question: Can we count a “complete” ROS when the surgeon includes a statement such as ...
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General Surgery Coding Alert - 2018; Volume 20, Number 7
ERCP Coding:
Grasp Rules for Biliary or Pancreatic Duct Procedures
Keep diagnostic and therapeutic codes separate. If your surgeons perform endoscopic retro...
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ICD-10-CM:
Follow Documentation, Definition, Deduction for Diagnosis Code
Wait for pathology report, if possible. When your surgeon performs a procedure that resul...
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Compliance:
Halt Fraud Accusations With 4 Teflon Tips
Make sure surgeons document medical necessity. You can keep your surgical practice out of...
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Reader Question:
Zero in on Known Diagnosis
Question: Our surgeon performed a fine-needle aspiration of the spleen for a patient diagn...
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Reader Question:
Focus E/M Coding With These Rules
Question: When coding an E/M chart, how do we know where the “current” conditions/symp...
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Reader Question:
Check Out This New QPP Lingo
Question: I've recently heard the term “promoting interoperability” regarding the QPP ...
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You Be the Coder:
Don't Confuse Cyst and FNA Aspirations
Question: If a surgeon performs a breast-cyst aspiration and submits the aspirate to patho...
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General Surgery Coding Alert - 2018; Volume 20, Number 6
Coding Quiz:
Test Yourself with Crohn's Surgical Case
Identify diagnosis, too. If your surgeon treats a patient with Crohn's disease who has bo...
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CCI 24.1:
Don't Stumble on 38573, 45395 Bundles
Know when '0' means 'no.' If you're getting suspicious denials for laparoscopic lymphaden...
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Coding Quiz:
Dissect This Crohn's Case for Multiple Procedures
Understand modifier 51 use. You have your answers for coding the Crohn's surgical case de...
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EHR Update:
Grasp Fed's New Plan to Overhaul Interoperability
Embrace patient-directed data sharing. According to a recent announcement from CMS, the h...
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Reader Question:
Guide Breast Biopsy Choice by Method
Question: Our surgeon performed a "stereotactic needle core biopsy" of breast tissue, remo...
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Reader Question:
Beware Stark Self-Referral
Question: If a few surgeons from our practice were to open an outpatient clinic for colono...
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Reader Question:
Focus on Observation Discharge
Question: A surgeon in our practice admitted a patient to the hospital for initial observa...
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Reader Question:
Pick One Enterolysis Code
Question: The surgeon performed an open limited lysis of adhesions in the abdominal cavity...
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You Be the Coder:
Distinguish AIDS, HIV This Way
Question: How do I know when to code for AIDS (B20), not HIV (Z21)? Tennessee Subscriber ...
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General Surgery Coding Alert - 2018; Volume 20, Number 5
CPT® 2018:
Update How You Report Deep-Tissue and Facial Pedicle Flaps
Focus on vascular pedicle to choose correct code. If you haven't taken the time to master...
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ICD-10:
Follow 4 Tips for Perfect Pressure Ulcer Dx
Look for site, severity, and more. When your surgeon treats pressure ulcers, you'll need ...
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E/M Coding:
Bust 4 'Prolonged Service' Coding Myths
Use codes according to published guidelines. If patient care extends beyond the typical t...
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Reader Question:
Know Measurement Rules for Melanoma Excision
Question: An op report describes melanoma re-excision of a 1.9 cm lesion with 0.1 cm margi...
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Reader Question:
See if History is Present or Past
Question: I'm new to E/M coding, and I'm confused about where the "current" conditions/sym...
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You Be the Coder:
Get Up to Speed on Imaging AUC
Question: We recently started using a CDSM module for imaging services in our surgical pra...
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General Surgery Coding Alert - 2018; Volume 20, Number 4
CPT® 2018:
Greet New Laparoscopic Peritoneal-Lymphadenectomy Code
38573 encompasses washings, biopsies, and more. Prior to January 1, only an unlisted code...
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ICD-10:
Don't Let 'Medical Necessity' Gap Undermine GI Surgery Pay
Focus coding for reported symptoms and final diagnoses. When your general surgeon takes a...
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HIPAA:
Ace Your Security Rule Compliance with 3 Tips
Lockdown physical and virtual access. HIPAA enforcement actions are bad news for the reci...
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Reader Question:
Check Payer Rules for GERD Procedure
Question: Our surgeon performed a laparoscopic esophageal sphincter augmentation by placin...
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Reader Question:
Focus on Details for Lap-Band Adjustment
Question: During an office visit, a surgeon in our practice performed a lap band adjustmen...
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Reader Question:
File Claims on Time
Question: We had a problem with a claim and didn't get it filed with Medicare until over a...
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You Be the Coder:
Colon Resection Connection Drives Code Choice
Question: I'm trying to code a note titled "partial colectomy," in which the surgeon descr...
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General Surgery Coding Alert - 2018; Volume 20, Number 3
CCI Update:
Master Version 24.0 Edits for Your Surgery Practice
Stay compliant with claims-filing rules. With loads of new CPT® codes effective in Janua...
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CCI Edits:
Galvanize Bundling Rules with Resources and Documentation
Know your payer's expectations. Although Correct Coding Initiative (CCI) bundles indicate...
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ICD-10:
Capture Underlying HIV Condition for Surgical Report
Alert payers to possible complications. When your surgeon performs a procedure on a patie...
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HIV Coding Quiz:
Gauge Your Answers Against the Experts'
Report AIDS in narrow circumstances. Making errors when reporting human immunodeficiency ...
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Reader Question:
Nail Down Method and Reason for Colonoscopy Code
Question: Our surgeon documented a colonoscopy for a 62-year-old female patient who had a ...
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Reader Question:
Get Hemorrhoid Coding Right
Question: The surgeon performed a flexible sigmoidoscopy for a patient who presented with ...
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Reader Question:
Check CCI for 2 Scopes
Question: Our surgeon performed a colonoscopy, removing one polyp, but he also documented ...
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Reader Question:
Look Ahead to Appropriate Use for Imaging
Question: To comply with the CMS rule about appropriate use for imaging, we recently added...
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Reader Question:
List Most Specific Diagnosis
Question: A primary care physician referred a patient suffering from symptoms such as a co...
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General Surgery Coding Alert - 2018; Volume 20, Number 2
CPT® 2018:
Update Bone Marrow Sampling With New, Revised Codes
Learn new way to report aspiration and biopsy together. When your surgeon extracts a bone...
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ICD-10-CM:
Diagnosis: It's Not Just For Medical Necessity Anymore
Your Dx choice can have 'quality' pay implications. If you think of diagnosis coding as t...
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E/M Focus:
Smash 5 Common E/M Coding Myths
Surgical visits may count toward 'established patient' status. You received E/M coding ad...
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Reader Question:
Clarify Diverticulosis Coding
Question: We have an op report from a colonoscopy in which the surgeon diagnosed diverticu...
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Reader Question:
Solve Catheter Insertion- Replacement- Removal-Mystery
Question: For a 72-year-old male patient, our surgeon removed a non-tunneled central venou...
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You Be the Coder:
Beware All-Encompassing Endograft Codes
Question: For a patient with an infrarenal aorta aneurysm that had not ruptured, our surge...
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General Surgery Coding Alert - 2018; Volume 20, Number 1
CPT® 2018:
Set Your Vascular Surgery Coding Course for Next Year
Drop some radiology codes for new, comprehensive service descriptors. If your surgeons pe...
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CPT® 2018:
Get the Scoop on Observation-Code Clarification
Place of service is key. Beginning Jan. 1, you will find a subtle but important revision ...
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Billing:
Find Resolution Options Beyond 'Appeal'
See if you qualify for low volume appeals settlement. If you hate appeals but aren't will...
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Reader Question:
Use Pathology Diagnosis for TURP After-Care
Question: Our surgeon performed a TURP procedure. When the patient came in for follow-up c...
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Reader Question:
Avoid 'Open' Trap for Bariatric Surgery Repair
Question: We had a patient return with complications following a gastric bypass procedure....
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You Be the Coder:
Don't Overuse Modifier 25
Question: Our surgeon saw a patient in the office who was referred by another physician fo...
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