General Surgery Coding Alert
Telehealth 2024:
Maximize Your Surgeons’ E/M Options Next Year
Add this clip-and-save chart to your telehealth toolbox. After adjusting to telehealth ch... Read more
Maximize Your Surgeons’ E/M Options Next Year
Add this clip-and-save chart to your telehealth toolbox. After adjusting to telehealth ch... Read more
Correct Coding:
Navigate NCCI Edits for Cleaner Claims
Learn how modifiers may help. Maybe you're aware that your coding software performs quart... Read more
Navigate NCCI Edits for Cleaner Claims
Learn how modifiers may help. Maybe you're aware that your coding software performs quart... Read more
Reimbursement:
Don’t Let Medicare Participation Myths Hit Your Bottom Line
Non-PAR can have mixed results. Just because you choose “non-PAR” Medicare status fo... Read more
Don’t Let Medicare Participation Myths Hit Your Bottom Line
Non-PAR can have mixed results. Just because you choose “non-PAR” Medicare status fo... Read more
Reader Question:
Don’t Miss Subsequent Vessels
Question: Treating thrombosis, the surgeon accessed the initial artery, placed vascul... Read more
Don’t Miss Subsequent Vessels
Question: Treating thrombosis, the surgeon accessed the initial artery, placed vascul... Read more
Reader Question:
Update Gastrostomy Tube Replacement Coding
Question: Our surgeon performed a percutaneous replacement of a gastrostomy tube. Alt... Read more
Update Gastrostomy Tube Replacement Coding
Question: Our surgeon performed a percutaneous replacement of a gastrostomy tube. Alt... Read more
Reader Question:
Distinguish Modifier 52, 53
Question: During a screening colonoscopy, the surgeon documented that the patient did... Read more
Distinguish Modifier 52, 53
Question: During a screening colonoscopy, the surgeon documented that the patient did... Read more
You Be the Coder:
Identify Site for Hernia Repair With Other Procedures
Question: The surgeon performed a laparoscopic gallbladder removal for a 37 year old ... Read more
Identify Site for Hernia Repair With Other Procedures
Question: The surgeon performed a laparoscopic gallbladder removal for a 37 year old ... Read more
CPT® 2024:
See If E/M Revisions Could Change Your Coding
Keep 99211 the same. Get ready for CPT® 2024 updates to some evaluation and management (... Read more
See If E/M Revisions Could Change Your Coding
Keep 99211 the same. Get ready for CPT® 2024 updates to some evaluation and management (... Read more
ICD-10-CM:
Join in Breast Cancer Awareness With This Coding Quiz
Hint: Don't ignore ‘history' codes. When providers in your surgery practice perform br... Read more
Join in Breast Cancer Awareness With This Coding Quiz
Hint: Don't ignore ‘history' codes. When providers in your surgery practice perform br... Read more
Coding Quiz Answer:
Check Your Breast Cancer Dx Coding Awareness Here
See if your ICD-10-CM guideline knowledge is passable. After you've answered the quiz que... Read more
Check Your Breast Cancer Dx Coding Awareness Here
See if your ICD-10-CM guideline knowledge is passable. After you've answered the quiz que... Read more
Office Visit:
Here Comes +G2211 for Extra E/M Pay
MPFS proposed rule slates implementation January 1. Your general surgeons could see a pay... Read more
Here Comes +G2211 for Extra E/M Pay
MPFS proposed rule slates implementation January 1. Your general surgeons could see a pay... Read more
Reader Questions:
Keep Family History HIPAA Compliant
Question: When our surgeon gets a referral for a procedure, the referring physician someti... Read more
Keep Family History HIPAA Compliant
Question: When our surgeon gets a referral for a procedure, the referring physician someti... Read more
Reader Questions:
Distinguish Foreign Body Removal Codes
Question: A patient presents two weeks after receiving two deep wounds in his upper arm fr... Read more
Distinguish Foreign Body Removal Codes
Question: A patient presents two weeks after receiving two deep wounds in his upper arm fr... Read more
Reader Questions:
Go to MACs for Claims-Based NCCI Quandaries
Question: If I have a question about appealing a claim that has been denied due to an NCCI... Read more
Go to MACs for Claims-Based NCCI Quandaries
Question: If I have a question about appealing a claim that has been denied due to an NCCI... Read more
Reader Questions:
Capture Relevant SDoH
Question: Our surgeon is treating a patient with diverticulosis, and the primary care phys... Read more
Capture Relevant SDoH
Question: Our surgeon is treating a patient with diverticulosis, and the primary care phys... Read more
You Be the Coder:
Avoid These Appendectomy Pitfalls
Question: Our surgeon began a laparoscopic appendectomy for a patient with signs of an inf... Read more
Avoid These Appendectomy Pitfalls
Question: Our surgeon began a laparoscopic appendectomy for a patient with signs of an inf... Read more
Medicare Physician Fee Schedule:
See How 2024 Proposed Rule Could Affect Your Practice
Expect surgical procedure pay cut … again. General surgeons should be on the lookout fo... Read more
See How 2024 Proposed Rule Could Affect Your Practice
Expect surgical procedure pay cut … again. General surgeons should be on the lookout fo... Read more
Query 4 Scenarios:
Code The Following Surgery Cases — Modifier(s) and All
Check your answers on page 4. Reporting procedures from your general surgeon's op report ... Read more
Code The Following Surgery Cases — Modifier(s) and All
Check your answers on page 4. Reporting procedures from your general surgeon's op report ... Read more
Code 4 Scenarios:
Check Your Scenario Answers — Modifier(s) and All
See the case examples on page 3. Now that you've read the four scenarios on page 3 and tr... Read more
Check Your Scenario Answers — Modifier(s) and All
See the case examples on page 3. Now that you've read the four scenarios on page 3 and tr... Read more
Reader Questions:
Focus Items That Count for E/M ‘Time’
Question: Our surgeon has performed an esophageal ablation of polyps for a patient in... Read more
Focus Items That Count for E/M ‘Time’
Question: Our surgeon has performed an esophageal ablation of polyps for a patient in... Read more
Reader Questions:
Code Neoplasm Based On Specific Location
Question: Our surgeon performed a breast biopsy from the “central portion” of the... Read more
Code Neoplasm Based On Specific Location
Question: Our surgeon performed a breast biopsy from the “central portion” of the... Read more
Reader Questions:
Know When Primary Payer is Medicare
Question: We have a patient on Medicare who is also insured through a group health p... Read more
Know When Primary Payer is Medicare
Question: We have a patient on Medicare who is also insured through a group health p... Read more
You Be the Coder:
Check Treatment Depth for Debridement Code Selection
Question: We have a case in which the surgeon documents sharp selective debridement w... Read more
Check Treatment Depth for Debridement Code Selection
Question: We have a case in which the surgeon documents sharp selective debridement w... Read more
ICD-10-CM:
Prepare for 2024 Dx Codes Relevant to Your General Surgery Practice
Apply these changes beginning Oct. 1 With almost 400 ICD-10-CM code additions and many de... Read more
Prepare for 2024 Dx Codes Relevant to Your General Surgery Practice
Apply these changes beginning Oct. 1 With almost 400 ICD-10-CM code additions and many de... Read more
Catheter Coding:
Focus on Clean Swan-Ganz Claims
Understand CVA edits. Your surgeon might perform Swan-Ganz catheter (SWC) procedures for ... Read more
Focus on Clean Swan-Ganz Claims
Understand CVA edits. Your surgeon might perform Swan-Ganz catheter (SWC) procedures for ... Read more
Appeals:
Use These 5 Tactics to Halt Denials
Prevent future errors by noticing current patterns. If you hate filing appeals for claim... Read more
Use These 5 Tactics to Halt Denials
Prevent future errors by noticing current patterns. If you hate filing appeals for claim... Read more
Reader Questions:
Protect Your Practice With Updated ABN
Question: I'm new to our surgery practice, but I noticed that the ABN form we're usi... Read more
Protect Your Practice With Updated ABN
Question: I'm new to our surgery practice, but I noticed that the ABN form we're usi... Read more
Reader Questions:
Use Unlisted Codes Appropriately
Question: During a laparoscopic procedure investigating a bulge in the patient's uppe... Read more
Use Unlisted Codes Appropriately
Question: During a laparoscopic procedure investigating a bulge in the patient's uppe... Read more
Reader Questions:
Code Final Dx First
Question: Our surgeon performed an exploratory EGD for a patient with persistent abd... Read more
Code Final Dx First
Question: Our surgeon performed an exploratory EGD for a patient with persistent abd... Read more
You Be the Coder:
Solve Digital Evaluation Troubles
Question: Our surgeon wants to use the digital E/M codes, but we're having difficulty... Read more
Solve Digital Evaluation Troubles
Question: Our surgeon wants to use the digital E/M codes, but we're having difficulty... Read more
Modifier 25:
Tighten Documentation Standards for E/M With Minor Surgery
Payers may make it harder to use this modifier. The good news is that Cigna once again de... Read more
Tighten Documentation Standards for E/M With Minor Surgery
Payers may make it harder to use this modifier. The good news is that Cigna once again de... Read more
Tech Update:
Code This When You Portal-Message Patients
Timing is everything. Treating a patient via a patient-portal conversation is an example... Read more
Code This When You Portal-Message Patients
Timing is everything. Treating a patient via a patient-portal conversation is an example... Read more
Medicare Policy:
Watch CMS Tighten Reins on Medicare Advantage Plans
Final rule focuses on equity and utilization review. If your practice provides services ... Read more
Watch CMS Tighten Reins on Medicare Advantage Plans
Final rule focuses on equity and utilization review. If your practice provides services ... Read more
Reader Questions:
Know When to Lead With Z Code
Question: Our surgeon performed a complex repair for a scar revision a year after the pati... Read more
Know When to Lead With Z Code
Question: Our surgeon performed a complex repair for a scar revision a year after the pati... Read more
Reader Questions:
Follow Rules for Medicare Overpayment
Question: Who is responsible for identifying and correcting overpayment in any Medicare re... Read more
Follow Rules for Medicare Overpayment
Question: Who is responsible for identifying and correcting overpayment in any Medicare re... Read more
Reader Questions:
Do This for Data Breach
Question: We identified a small data breach in our system that impacted 97 patients. Becau... Read more
Do This for Data Breach
Question: We identified a small data breach in our system that impacted 97 patients. Becau... Read more
You Be the Coder:
Focus ERCP Coding
Question: Our surgeon performed ERCP to remove three stones from the bile duct. The surgeo... Read more
Focus ERCP Coding
Question: Our surgeon performed ERCP to remove three stones from the bile duct. The surgeo... Read more
Surgery Case:
Grasp Documentation Details for Pressure Ulcer Px and Dx Coding
Distinguish physician work from other providers'. When your general surgeon treats... Read more
Grasp Documentation Details for Pressure Ulcer Px and Dx Coding
Distinguish physician work from other providers'. When your general surgeon treats... Read more
Telehealth:
Understand Virtual Visits Post-PHE
Keep up with digital encounters. Now that the COVID-19 public health emergency (PHE) has... Read more
Understand Virtual Visits Post-PHE
Keep up with digital encounters. Now that the COVID-19 public health emergency (PHE) has... Read more
Documentation:
Don’t Let ‘Authorization’ Lead Code Selection
Undercoding can cost you. When a scheduled surgical procedure takes an unexpected turn t... Read more
Don’t Let ‘Authorization’ Lead Code Selection
Undercoding can cost you. When a scheduled surgical procedure takes an unexpected turn t... Read more
Reader Questions:
Look to Documentation for ‘Acute’ or ‘Chronic’ Designation
Question: How can I tell if a condition is “acute” or “chronic?” I'm confuse... Read more
Look to Documentation for ‘Acute’ or ‘Chronic’ Designation
Question: How can I tell if a condition is “acute” or “chronic?” I'm confuse... Read more
Reader Questions:
Don’t Count on Consecutive Time
Question: One of our providers wants to bill an evaluation and management (E/M) visit... Read more
Don’t Count on Consecutive Time
Question: One of our providers wants to bill an evaluation and management (E/M) visit... Read more
Reader Questions:
Use Modifier 51 With Caution
Question: When our surgeon performs FNA with ultrasound guidance at two anatomic site... Read more
Use Modifier 51 With Caution
Question: When our surgeon performs FNA with ultrasound guidance at two anatomic site... Read more
You Be the Coder:
Consider Test Order for MDM
Question: During an office visit, the surgeon ordered specific lab tests for inflamma... Read more
Consider Test Order for MDM
Question: During an office visit, the surgeon ordered specific lab tests for inflamma... Read more
CPT® 2023:
Delve Deeper For Hernia Repair Coding Update
Know size measurement rules. After a few months of coding hernia repairs using the CPT® ... Read more
Delve Deeper For Hernia Repair Coding Update
Know size measurement rules. After a few months of coding hernia repairs using the CPT® ... Read more
Recognize Impact of 0-Day Global Period
As you just read in “Delve Deeper For Hernia Repair Coding Update,” CPT® 2023 delete... Read more
As you just read in “Delve Deeper For Hernia Repair Coding Update,” CPT® 2023 delete... Read more
Practice Management:
Refresh Your HIPAA Compliance Know-How
Waivers end with PHE. With the end of the COVID-19 public health emergency (PHE) this mon... Read more
Refresh Your HIPAA Compliance Know-How
Waivers end with PHE. With the end of the COVID-19 public health emergency (PHE) this mon... Read more
E/M:
Follow This Expert Advice for Inpatient/Observation Codes
See when office care leads to ‘subsequent' hospital care. With the overhaul of hospit... Read more
Follow This Expert Advice for Inpatient/Observation Codes
See when office care leads to ‘subsequent' hospital care. With the overhaul of hospit... Read more
Reader Questions:
Capture Mesh Removal
Question: Do the new anterior abdominal hernia repair codes include removal of mesh,... Read more
Capture Mesh Removal
Question: Do the new anterior abdominal hernia repair codes include removal of mesh,... Read more
Reader Questions:
See The ESD EMR Difference
Question: During a colonoscopy, our surgeon documented removing a large colon polyp u... Read more
See The ESD EMR Difference
Question: During a colonoscopy, our surgeon documented removing a large colon polyp u... Read more
You Be the Coder:
Distinguish Lesion ‘Excision’ and ‘Destruction’ Codes
Question: The op report identifies a 1.5 cm basal cell carcinoma diagnosed by prior b... Read more
Distinguish Lesion ‘Excision’ and ‘Destruction’ Codes
Question: The op report identifies a 1.5 cm basal cell carcinoma diagnosed by prior b... Read more
E/M:
Hone Critical Care Coding With CPT® and Medicare Rules
Don't unbundle 99291 services. Just because CPT® 2023 didn't revise critical care codes ... Read more
Hone Critical Care Coding With CPT® and Medicare Rules
Don't unbundle 99291 services. Just because CPT® 2023 didn't revise critical care codes ... Read more
ICD-10-CM:
Know Your Anatomy to Master New Aortic Aneurysm Dx Options
Ignore ‘Code first' notes at your peril. If your practice includes vascular surgery, ... Read more
Know Your Anatomy to Master New Aortic Aneurysm Dx Options
Ignore ‘Code first' notes at your peril. If your practice includes vascular surgery, ... Read more
COVID-19:
Prepare Your Practice for the PHE’s End
Identify expiring waivers that impact your surgeons. The COVID-19 public health emergen... Read more
Prepare Your Practice for the PHE’s End
Identify expiring waivers that impact your surgeons. The COVID-19 public health emergen... Read more
Reader Questions:
Check Out Hot Biopsy Forceps
Question: The surgeon performed a “hot biopsy” for a polypectomy, according to th... Read more
Check Out Hot Biopsy Forceps
Question: The surgeon performed a “hot biopsy” for a polypectomy, according to th... Read more
Reader Questions:
Don’t Forget to ‘Code First’
Question: Our surgeon performed a colonoscopy for a patient with a personal history o... Read more
Don’t Forget to ‘Code First’
Question: Our surgeon performed a colonoscopy for a patient with a personal history o... Read more
Reader Questions:
Don’t Drop History and Exam
Question: With all the changes to E/M codes starting with office codes and now many o... Read more
Don’t Drop History and Exam
Question: With all the changes to E/M codes starting with office codes and now many o... Read more
Reader Questions:
Master This MUE ‘Override’ Guidance
Question: Our surgeon performed an open procedure and excised two distinct stomach b... Read more
Master This MUE ‘Override’ Guidance
Question: Our surgeon performed an open procedure and excised two distinct stomach b... Read more
You Be the Coder:
Use Modifier 22 Instead of ‘Separate Procedure’
Question: During a cholecystectomy using the laparoscope, the surgeon documented spen... Read more
Use Modifier 22 Instead of ‘Separate Procedure’
Question: During a cholecystectomy using the laparoscope, the surgeon documented spen... Read more
Case Study:
Highlight Tonsillectomy Coding Nuance With This Op Note
Don't miss the pathogen Dx code. Tonsillectomy may be an everyday occurrence for general... Read more
Highlight Tonsillectomy Coding Nuance With This Op Note
Don't miss the pathogen Dx code. Tonsillectomy may be an everyday occurrence for general... Read more
Vascular Surgery:
Follow 5 Tips for Clean Mechanical Thrombectomy Claims
Distinguish ‘primary' and ‘secondary' procedures. When your vascular surgeons remove ... Read more
Follow 5 Tips for Clean Mechanical Thrombectomy Claims
Distinguish ‘primary' and ‘secondary' procedures. When your vascular surgeons remove ... Read more
Practice Management:
Query Providers This Way to Improve Documentation
Focus on guidelines for complete records. You know that clinical documentation is key ... Read more
Query Providers This Way to Improve Documentation
Focus on guidelines for complete records. You know that clinical documentation is key ... Read more
Reader Questions:
Look for Long COVID Dx Guidance
Question: Our surgeon stated that a patient had “long COVID” as a secondary diag... Read more
Look for Long COVID Dx Guidance
Question: Our surgeon stated that a patient had “long COVID” as a secondary diag... Read more
Reader Questions:
Keep On Top of QPP Updates
Question: I'm newly in charge of the QPP program for our practice, and I'm wondering ... Read more
Keep On Top of QPP Updates
Question: I'm newly in charge of the QPP program for our practice, and I'm wondering ... Read more
Reader Questions:
Avoid This Locum Tenens Mistake
Question: We have a surgeon who left our practice, and we're wondering if we can stil... Read more
Avoid This Locum Tenens Mistake
Question: We have a surgeon who left our practice, and we're wondering if we can stil... Read more
You Be the Coder:
Avoid 99211 for New Patient
Question: I've been told I should use 99211 for a nurse's time with a new patient in ... Read more
Avoid 99211 for New Patient
Question: I've been told I should use 99211 for a nurse's time with a new patient in ... Read more
Coverage Rules:
Capture Pay for Expanded CRC Screening Procedures
See impact on colonoscopy, flexible sigmoidoscopy. If you haven't incorporated colorecta... Read more
Capture Pay for Expanded CRC Screening Procedures
See impact on colonoscopy, flexible sigmoidoscopy. If you haven't incorporated colorecta... Read more
2023 Appropriations:
Discover 4 CAA Actions That General Surgeons Need
You'll get more than conversion factor relief. You heard the outcry over impending Medi... Read more
Discover 4 CAA Actions That General Surgeons Need
You'll get more than conversion factor relief. You heard the outcry over impending Medi... Read more
HIPAA:
Avoid a Security Breach With These Email Tips
Continuously coach staff for best protection. One of the easiest ways for your practice... Read more
Avoid a Security Breach With These Email Tips
Continuously coach staff for best protection. One of the easiest ways for your practice... Read more
Reader Questions:
Match Code Selection to Documented EGD Work
Question: Our surgeon advanced a scope through the esophagus into the stomach using ... Read more
Match Code Selection to Documented EGD Work
Question: Our surgeon advanced a scope through the esophagus into the stomach using ... Read more
Reader Questions:
Drill Down to Dx Specifics for Thromboendarterectomy Case
Question: Our vascular surgeon performed a right popliteal endarterectomy for a patie... Read more
Drill Down to Dx Specifics for Thromboendarterectomy Case
Question: Our vascular surgeon performed a right popliteal endarterectomy for a patie... Read more
Reader Questions:
Prepare for the COVID-19 PHE Expiration
Question: Did the COVID-19 public health emergency expire? Iowa Subscriber Answer:&... Read more
Prepare for the COVID-19 PHE Expiration
Question: Did the COVID-19 public health emergency expire? Iowa Subscriber Answer:&... Read more
You Be the Coder:
Clip This Handy ‘Prolonged Service’ Chart
Question: I'm very confused by the change to prolonged service coding for 2023. Could... Read more
Clip This Handy ‘Prolonged Service’ Chart
Question: I'm very confused by the change to prolonged service coding for 2023. Could... Read more
CPT® 2023:
Capture Pay for Mesh Implantation, Suture/Staple Removal
Look for new and revised codes. General surgeons have several new and revised integumenta... Read more
Capture Pay for Mesh Implantation, Suture/Staple Removal
Look for new and revised codes. General surgeons have several new and revised integumenta... Read more
MPFS 2023:
Navigate Telehealth Rules Through PHE and Beyond
Don't miss CPT® 2023 E/M code changes. The rapid expansion of Medicare payment for tele... Read more
Navigate Telehealth Rules Through PHE and Beyond
Don't miss CPT® 2023 E/M code changes. The rapid expansion of Medicare payment for tele... Read more
CPT® 2023:
Don’t Miss New Appendix S for AI Taxonomy
Understand different levels of machine involvement. If you missed the fact that the CPT®... Read more
Don’t Miss New Appendix S for AI Taxonomy
Understand different levels of machine involvement. If you missed the fact that the CPT®... Read more
Reader Questions:
Don’t Count All Time for E/M
Question: Now that we can code many E/M services based on time, and we can use more t... Read more
Don’t Count All Time for E/M
Question: Now that we can code many E/M services based on time, and we can use more t... Read more
Reader Questions:
Focus Carotid Artery Endarterectomy Coding
Question: Our surgeon treated a patient with severe blockage of the right carotid ar... Read more
Focus Carotid Artery Endarterectomy Coding
Question: Our surgeon treated a patient with severe blockage of the right carotid ar... Read more
Reader Questions:
Get MIPS Reweighting for COVID-19 Hardship
Question: Our general surgery practice was strongly impacted by COVID-19, and we'd li... Read more
Get MIPS Reweighting for COVID-19 Hardship
Question: Our general surgery practice was strongly impacted by COVID-19, and we'd li... Read more
Reader Questions:
Classify Internal and External Hemorrhoid Case
Question: Our surgeon excised a column of hemorrhoids that begins above the denate li... Read more
Classify Internal and External Hemorrhoid Case
Question: Our surgeon excised a column of hemorrhoids that begins above the denate li... Read more
You Be the Coder:
Clarify ‘Established Patient’
Question: We have a new general surgeon in our group who is now treating one patient ... Read more
Clarify ‘Established Patient’
Question: We have a new general surgeon in our group who is now treating one patient ... Read more
CPT® 2023:
Sidestep 4 Pitfalls When Reporting E/M by Time
Make sure to document non-face-to-face work. Now that CPT® has revised the list of eval... Read more
Sidestep 4 Pitfalls When Reporting E/M by Time
Make sure to document non-face-to-face work. Now that CPT® has revised the list of eval... Read more
Medicare Outlook:
Prepare for Big Fee Reduction in 2023
You could face negative 8.5 percent adjustment unless Congress intervenes. As if industry... Read more
Prepare for Big Fee Reduction in 2023
You could face negative 8.5 percent adjustment unless Congress intervenes. As if industry... Read more
Surprise Billing:
Abide By Final ‘No Surprises Act’ in Your Surgery Practice
Notice that court decisions impact the rules. With yet another round of modifications to ... Read more
Abide By Final ‘No Surprises Act’ in Your Surgery Practice
Notice that court decisions impact the rules. With yet another round of modifications to ... Read more
Reader Question:
Pinpoint Age for Catheter Code Selection
Question: Our surgeon inserted a central venous access catheter in a 4-year-old patie... Read more
Pinpoint Age for Catheter Code Selection
Question: Our surgeon inserted a central venous access catheter in a 4-year-old patie... Read more
Reader Question:
Don’t Tread on HIPAA Right of Access
Question: We have a patient with a large balance who has not responded to requests fo... Read more
Don’t Tread on HIPAA Right of Access
Question: We have a patient with a large balance who has not responded to requests fo... Read more
Reader Question:
Cancel This 43233 Without Dilation
Question: During an upper GI endoscopy, the surgeon had difficulty passing the dilato... Read more
Cancel This 43233 Without Dilation
Question: During an upper GI endoscopy, the surgeon had difficulty passing the dilato... Read more
You Be the Coder:
Skip Removal Codes
Question: How should we code a case where the surgeon removes obstructive material fr... Read more
Skip Removal Codes
Question: How should we code a case where the surgeon removes obstructive material fr... Read more