Accurately Identify a Separate Procedure
Published on Wed Oct 10, 2012
Medicare has clear guidelines for separate procedure.Having clear documentation of the procedures your surgeon is doing and why one procedure is being listed as a separate procedure in your claim will make all the difference in your claims success. Medicare has a clear definition about what constitutes a separate surgical procedure. According to Josie Dunn, CPC, at the University of Maryland Faculty Practices, Maryland, Medicare states: "The CPT® surgery guidelines further state that the codes listed as 'separate procedure' should not be reported in addition to the code for the total procedure or service. In other words, report a separate procedure if it is not performed with a primary procedure that encompasses the 'separate' one, or when it adds 'appreciably to the time and/or complexity of the procedure.'Below is what Heidi Stout, BA, CPC, COSC, PCS, CCS-P, Coder on Call, Inc., Milltown, New Jersey and director of orthopedic coding division, The [...]
