CCI 18.0: Extract The Meaning Behind These New Pelvic Repair, Paracentesis Edits   (January 2012)

You learned how to use the new codes; now you have to apply these bundles.
You may just be digging in to your 2012 CPT® book, but the Correct Coding Initiative (CCI) has already taken aim at some of the new codes by bundling them into existing codes effective Jan. 1.

Background: The CCI released version 18.0 at the end of 2012, revealing 15,530 new active pairs and 6,197 code pair deletions, said Frank D. Cohen, [...]

Pessary: Start and Finish Your Pessary Coding With This Solid Strategy   (January 2012)

Find out if your ob-gyn did a refitting at the time of a pessary insertion.
If you think 57160 is all you need for pessary insertion procedures, think again. Not only will you have to consult your HCPCS and ICD-9 manuals, you must follow your practice’s policy on whether the patient or you are responsible for the supplies.
Pick Out Pertinent Pessary Dx
A pessary is a “support device for pelvic-floor weakness, such as uterine prolapse, vaginal prolapse [...]

Gynecology: Answer 3 Questions to Bolster Your Biopsy Coding Efficiency   (January 2012)

The number of biopsy units doesn’t always go by the number of samples.Are you sure you’re getting the reimbursement your ob-gyn deserves for biopsy procedures? Take this quiz and avoid the many pitfalls of biopsy coding and billing.Background: A biopsy is a tissue sample that the ob-gyn excises from the patient to ascertain the presence of cancer. Ob-gyns will most likely perform biopsies of the vulva, cervix, vagina, endometrium and ovary(s). Ob-gyns usually order a [...]

ICD-10: Here’s What Documentation You Need to Report Twin Pregnancies in 2013   (January 2012)

Tip: Despite unspecified codes, submit dx with the highest level of specificity.A twin pregnancy is one where the mother carries two fetuses. This may include one placenta and one amniotic sac, one placenta and two amniotic sacs, or two placentae and two amniotic sacs.To correctly report twin pregnancies in ICD-10, your provider has to document the following: twin pregnancy specific trimester number of placentae number of amniotic sacsICD-9-CM Codes: Here is how you currently report [...]

You Be the Coder: Modifiers 51, 52: Focus on What Services Physician Performed   (January 2012)

Question: My ob-gyn did a paratubal cyst excision when done at the time of a c-section. I know to use 4920X based on size, but should I use modifier 52 because the surgeon is already in the abdomen?South Carolina SubscriberAnswer: The answer depends on who performed what service. Same physician: You should not apply modifier 52 (Reduced services) to 4920X (Excision or destruction, open, intra-abdominal tumors, cysts or endometriomas, 1 or more peritoneal, mesenteric, or [...]

Reader Question: Correct Your Implanon/Nexplanon Codes on Your Encounter Form   (January 2012)

Question: I’m updating my encounter forms for 2012. Now that 11975 and 11977 are no longer valid, are these codes correct?Implanon insertion: 11981Implanon removal: 11976Implanon removal and insertions: 11976 and 11981Colorado SubscriberAnswer: Not quite. Code 11976 was left in CPT to report the removal of the capsules for the Norplant system. Here are the correct codes:Implanon insertion: 11981 (Insertion, non-biodegradable drug delivery implant)Implanon removal:11982 (Removal, non-biodegradable drug delivery implant)Implanon removal and Implanon reinsertion: 11983 (Removal [...]

Reader Question: Discover this Sterilization, Salpingectomy Solution   (January 2012)

Question:My ob-gyn documented the following note:Procedure: Lap TubalDocumented procedure: The fallopian tubes are cut, laparoscopically. I stitched ends, and then I removed the remainder of the fallopian tubes.How should I code this?California SubscriberAnswer: Whether he removes the tubes or not, this is a sterilization procedure and not a salpingectomy. Therefore, you should report only 58670 (Laparoscopy, surgical; with fulguration of oviducts [with or without transection]).

Reader Question: Get Specific With Your Counseling V Code   (January 2012)

Question: My ob-gyn saw a patient with a fetal demise at 17 weeks 2 days. The patient came back to our clinic for a follow up visit to discuss the autopsy results. Here is what my ob-gyn reported:Patient here to discuss autopsy results. Only finding was right hand with absent thumb, fused 2nd-3rd fingers and overlapping 4th and 5th. Reviewed with genetic counselor and she could not find any associated syndromes etc. Discussed small risk [...]

Reader Question: Should You Include Paratubal Cyst Incision in 58661? Find Out   (January 2012)

Question: The physician performed a left salpingo-oophorectomy with drainage of right paratubal cyst and lysis of adhesions. Would the ASPIRATION of the paratubal cyst be included in the salpingo-oophorectomy (58661)?Maryland SubscriberAnswer: No. You should report 58661 (Laparoscopy, surgical; with removal of adnexal structures [partial or total oophorectomy and/or salpingectomy]) with 49322 (Laparoscopy, surgical; with aspiration of cavity or cyst [e.g., ovarian cyst] [single or multiple]). Remember, as per the latest Correct Coding Initiative (CCI) edits, [...]

Reader Question: Established Patients Last 3 Years   (January 2012)

Question: We saw a patient over a year ago for a cystectomy, and now the patient came back with extreme lower right quadrant pain and our surgeon performed a hysterectomy. Should we bill the hysterectomy as a new patient since she’s coming back for a different reason?Idaho SubscriberAnswer: No, you should not bill this case as a new patient. You should bill this as an established patient for several reasons.If your ob-gyn sees a patient [...]