General Surgery Coding Alert
BundledJejunostomy and Mesh Removal
The February 2003 General Surgery Coding Alert ("Watch for Bundled Jejunostomy") should have stated that +44015 (Tube or needle catheter jejunostomy for enteral alimentation, intraoperative, any method [list separately in addition to primary procedure]) is not bundled to the Whipple procedure. The pancreato-jejunostomy referred to in the Whipple procedure descriptor describes anastomosis of the pancreatic ducts to the jejunum, not placement of a feeding tube as indicated by 44015. Therefore, you may report 44015 separately with 48150-48154 (Pancreatectomy ...). Additionally, the April 2003 "You Be the Coder" ("Is 49085 Correct for Mesh Removal?") should have recommended 20525* (Removal of foreign body in muscle or tendon sheath; deep or complicated) as the correct code for deep mesh removal.
General Surgery Coding Alert
- Part 1:
Visualize Better Payment for Sentinel Node Biopsy Procedures
Although the AMA and CPT state that you shouldnt use 38792 and 78195 during the [...] - Part 1:
Understand Global Periods and Avoid a World of Hurt
So-called "global" periods which define a package of services or care associated with and bundled [...] - You Be The Coder:
Get Preauthorization for Varicose Vein Injections
Question: Payers routinely reject our claims for varicose vein injections. What are we doing wrong? [...] - CCI 9.1:
New Companions for Caths,Pancreatic Procedures
Of the more than 4,700 changes to the national Correct Coding Initiative (CCI) this quarter [...] - Global-Period Lengths Vary
Under Medicare guidelines as established by the Physician Fee Schedule, there are four primary global [...] - Correction:
BundledJejunostomy and Mesh Removal
The February 2003 General Surgery Coding Alert ("Watch for Bundled Jejunostomy") should have stated that [...] - READER QUESTION:
Medicare Specifies -AS for PAs in Surgery
Question: In the past, Ive always reported modifier -80 for a certified PA in the [...] - READER QUESTION:
Significant Additional Work Warrants -22
Question: If the physician spends an additional 30 minutes lysing adhesions during a laparoscopic chole-cystectomy, [...] - READER QUESTION:
No Fixed Guidelines for -63
Question: What can you tell me about the new-for-2003 modifier -63? Georgia Subscriber Answer: Insurers [...] - Keep an Eye on Observation Coding to Avoid Blurry E/M Reporting
Many general surgery coders have no trouble following CPT rules for hospital observation services, but [...] - You Be the Coder:
Face-to-Face Time During Counseling Sessions
Question: Our surgeon spent time during an office visit counseling a new patient prior to [...] - 3 Guidelines for Better Discharge Reimbursement
General surgery coders may not use hospital discharge services codes often, but when they do, [...] - Emphasize Surgeons Expertise To Increase Concurrent Care Pay
When a surgeon works concurrently with other physicians to treat a patient, you'll stand a [...] - READER QUESTION:
Include Consult in ED Observation
Question: If the emergency department (ED) physician requests a consultation from a surgeon for a [...] - READER QUESTION:
Treat Two-Surgeon Visits Individually
Question: How should we report the following situation: Dr. Afrom our surgery group admits a [...] - READER QUESTION:
Same-Day Discharges Get Single Code
Question: One of our surgeons saw a patient in the hospital and coded the visit [...] - READER QUESTION:
Pre-Op Visits Require Medical Necessity
Question: Our surgeon wants to send a patient back to her primary-care physician (PCP) for [...] - READER QUESTION:
Report NP Work for Surgical Assist
Question: Two providers (one a surgeon and the other a nurse practitioner [NP]) worked together [...]
