Orthopedic Coding Alert

You-ll capture every allowed procedure with these tips.

Injuries won't be able to lurk in documentation and remain unpaid due to lack of modifiers if you keep this payment success recipe handy. To get the most from your coding, Edwards says remember to:

1. Educate your physician concerning the details you need. If there are issues with documentation let him know what he is missing. Hint that a new paragraph for each injury is very helpful.

2. Identify every procedure and associated diagnosis code.

3. Identify each physician and his or her specialty and group.

4. Code according to physician group with the appropriate modifier.

5. Determine the cause of a return trip to the OR to choose the appropriate modifier.

6. Check the CCI edits for bundling issues.

7. Code every procedure great or small if it affects separate anatomical sites. If the injury is distinct in nature modifier 59 or anatomical modifiers may be required.

8. Have a mechanism to alert coders that a physician in the practice with the same specialty has established a global.

9. Know what private payers require for the complex issues we-ve discussed.

10. Always support your coding with proper guidelines and documentation.