Code This!: Decipher Complicated Transrectal Biopsy Case Coding   (February 2012) First Release

How would you report this procedure?
Test your operative report interpretation skills with this case study from a Urology Coding Alert subscriber in New York.
I have a case where I?m having trouble assigning the CPT code(s). Here is the operative report:
Nature of Operation: Transrectal ultrasound-guided biopsy of perivesical mass/periurethral tissues
Indication: Patient has a history of prior radical prostatectomy with lymph node dissection. Endorectal MRI of the pelvis identifies tissue bilaterally along the region of the [...]

CCI 18.0: Skip Catheterization Coding With Still More Procedures, According to CCI   (January 2012)

Plus, you’ll find 51597 bundles several procedures now as well.
Every year at this time you’re faced with new and revised codes you need to learn and just when you think you have the changes mastered, the Correct Coding Initiative (CCI) comes along and throws coding restrictions at you.
The CCI released version 18.0 at the end of 2011, revealing 15,530 new active pairs and 6,197 code pair deletions, said Frank D. Cohen, MPA, MBB, senior analyst [...]

ICD-10: Prostate Cancer Coding Mirrors ICD-9 Neoplasm Table Structure   (January 2012)

Hint: You’ll apply the same PIN rules even when the codes change.
If you don’t have any trouble using the ICD-9 neoplasm table, you shouldn’t have a hard time transitioning to ICD-10 neoplasm codes starting Oct. 1, 2013.
For example, here’s how the two code set options for malignant prostate cancer coding compare:
ICD-9: Under ICD-9, your prostate neoplasm options include:
Primary: 185, Malignant neoplasm of prostate
Secondary: 198.82, Secondary malignant neoplasm of genital organs
Ca in Situ: 233.4, Carcinoma in [...]

CCI 2012 Update: Learning the Latest CCI Bundles Isn’t Enough — Get to Know the Overarching Manual Changes, Too   (January 2012)

CMS offers clear guidance on what to include in pelvic exenteration coding.
Although coders mostly think about the quarterly lists of coding bundles when it comes to the Correct Coding Initiative (CCI), there is another side to national bundling rules — the National Correct Coding Initiative Policy Manual. And thanks to a Jan. 2012 update, you should peruse the manual to determine what’s changed this year.
We have the lowdown on a few important changes that are [...]

News You Can Use: You’ll Be Spared a 27 Percent Pay Cut — At Least Until the End of February   (January 2012)

At nearly the last minute, Congress votes to boost conversion factor.
Although the government appeared poised to take a big bite out of your Medicare payments, you have another two months before you need to worry about losing pay. That’s because the 27 percent Medicare pay cuts that practices have feared since last fall were once again kicked to the curb by Congress, resulting in a new, but most likely, temporary Medicare Physician Fee Schedule conversion [...]

News You Can Use: Figure Out Which 5010 Category Your Practice Falls Under   (January 2012)

Watch out: Not everyone will have until March 31 to comply.
You thought you wouldn’t face enforcement action regarding 5010 compliance until March 31, 2012. Now CMS tells providers that they are being watched carefully — and that some of them will not actually have until March to switch to 5010.
CMS Accelerates Changeover
In a Dec. 14, 2011 news release, CMS announced that it is monitoring progress toward 5010 compliance and has found that some practices are [...]

You Be the Coder: Reposition Your Return to OR Coding With Modifiers   (January 2012)

Question:
A patient had an artificial urinary sphincter inserted and later on that night, leaned over and felt a “pop” in his groin. He was returned to the OR for repositioning of the reservoir. What code would I use for that?
Oregon Subscriber
Answer:
You should report 54405 (Insertion of multicomponent, inflatable penile prosthesis, including placement of pump, cylinders, and reservoir) for the repositioning procedure.
You’ll need to append modifier 76 (Repeat procedure or service by same physician or [...]

Reader Question: Laparoscopic Retroperitoneal Lymph Node Dissection Requires 38589   (January 2012)

Question:
Which is the correct code for a laparoscopic retroperitoneal lymph node dissection (periaortic and interaortocaval lymph nodes)?
Texas Subscriber
Answer:
You should report 38589 (Unlisted laparoscopic procedure, lymphatic system) as there is no specific CPT® code for this laparoscopic procedure.
When you submit an unlisted code you should always include a cover letter with your claim explaining that you have searched the 2012 active CPT® manual and found no specific code for the procedure your urologist performed, and therefore, [...]

Reader Question: 53502: Confirm Gender Before Coding   (January 2012)

Question:
We have a patient that previously had a creation of a Mitrofanoff and closure of the bladder neck. Now she is leaking urine from her urethra. My doctor does urethral ligation through a vaginal approach and excises a small segment of urethra and over sews the distal and proximal ends resulting in a tight closure of the urethra. How should I report this?
Indiana Subscriber
Answer:
You should report 51800 (Cystoplasty or cystourethroplasty, plastic operation on bladder and/or [...]

Reader Question: Choose 50544 For a Robotic UPJ Obstruction Repair   (January 2012)

Question:
How would I code a robotic ureteropelvic junction repair?
Florida Subscriber
Answer:
You should report 50544 (Laparoscopy, surgical, pyeloplasty) for the robotic ureteropelvic junction (UPJ) repair.