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General Surgery Coding Alert

ICD-10-CM 2019:
Tackle New Infection, Abscess, Gallbladder Codes and More
OB infections are different. With so many new diagnosis codes that could impact your gene... Read more
Skin Surgery Basics:
Answer 4 Questions to Focus Skin Coding Options
Define depth for shaving codes. Maybe you can drill down to the correct procedure code fo... Read more
HIPAA:
Grasp Real Penalty Risk for Privacy Violations
Having a program is not enough. You might think you’re safe from enforcement action if ... Read more
Reader Question:
Finalize Dx from Pathology
Question: Our surgeon performed a retroperitoneal exploratory laparoscopic surgery with a ... Read more
Reader Question:
File Timely Claim or Lose Pay
Question: We had a problem with a claim and didn’t get it filed with Medicare until over... Read more
Reader Question:
Pinpoint Fluid Extraction Method
Question: The surgeon extracted a fluid sample from an ovarian cyst using ultrasound guida... Read more
You Be the Coder:
Distinguish MUE and PTP CCI Edits
Question: What is the difference between Medically Unlikely Edits and Mutually Exclusive E... Read more
ICD-10-CM Update:
Embrace New Dx Coding Options for Your Surgery Practice
Don’t forget ‘X’ place holder. With 320 new and 170 revised diagnosis codes in ICD-... Read more
Inpatient E/M:
3 Tips Focus Subsequent Care Coding
Avoid consultation codes for Medicare. When your surgeon provides ensuing E/M services to... Read more
Subsequent-Care E/M:
Avoid Surgical Conflicts with 99231-99233
Pay attention to global period. If your surgeon performs an inpatient procedure that has ... Read more
Reader Question:
Marshal E/M Plus Surgery Pay
Question: A patient presents to the emergency room with nausea and severe lower-right abdo... Read more
Reader Question:
Distinguish Anoscopy, Proctosigmoidoscopy
Question: A patient presented with frequent constipation and blood in the stool. The surge... Read more
Reader Question:
Use MIPS Lookup Tool for Your Reporting Requirements
Question: Our practice is transitioning to MIPS, but I’m unclear whether we should send ... Read more
Reader Question:
Understand Scalp "and/or" Neck
Question: Our surgeon removed a Merkel cell carcinoma from the scalp. Should we code this ... Read more
You Be the Coder:
Include Excision in Z-Plasty
Question: Our surgeon performed a scar revision procedure on the patient’s right forearm... Read more
Integumentary System:
Bungle Skin Biopsy Coding and Lose Pay
Look for site-specific codes. If you think 11100-+11101 are the only codes that describe ... Read more
Clip and Save:
Sacrifice Up To $97 per Lesion for 11100 Misuse
Look beyond integumentary codes. You learned in “Bungle Skin Biopsy Coding and Lose Pay... Read more
Remittance Advice:
Keep CARC/RARC Current to Track Payment and Denials
Update files from WPC website. Who knew that the Remittance Advice (RA) statement you rec... Read more
Reader Question:
Follow Tips for Record Disposal when Moving
Question: Our surgery practice is moving to a new location, and we’re purging old patien... Read more
Reader Question:
Use Payer Policy for Coverage Clues
Question: We recently got a denial from Aetna for an EGD procedure for a 10-year-old patie... Read more
Reader Question:
Grasp This: Abdominal Codes Include Enterolysis
Question: Sometimes our surgeon performs a partial colectomy, either open or laparoscopic,... Read more
Reader Question:
Third Time's the Charm
Question: We always try to collect copays and deductibles from patients as required by the... Read more
Reader Question:
HIPAA Holds After Death
Question: Do HIPAA regulations require us to maintain a patient’s private health informa... Read more
You Be the Coder:
Avoid '10 Negative ROS' Pitfall
Question: Can we count a “complete” ROS when the surgeon includes a statement such as ... Read more
ERCP Coding:
Grasp Rules for Biliary or Pancreatic Duct Procedures
Keep diagnostic and therapeutic codes separate. If your surgeons perform endoscopic retro... Read more
ICD-10-CM:
Follow Documentation, Definition, Deduction for Diagnosis Code
Wait for pathology report, if possible. When your surgeon performs a procedure that resul... Read more
Compliance:
Halt Fraud Accusations With 4 Teflon Tips
Make sure surgeons document medical necessity. You can keep your surgical practice out of... Read more
Reader Question:
Zero in on Known Diagnosis
Question: Our surgeon performed a fine-needle aspiration of the spleen for a patient diagn... Read more
Reader Question:
Focus E/M Coding With These Rules
Question: When coding an E/M chart, how do we know where the “current” conditions/symp... Read more
Reader Question:
Check Out This New QPP Lingo
Question: I’ve recently heard the term “promoting interoperability” regarding the QP... Read more
You Be the Coder:
Don't Confuse Cyst and FNA Aspirations
Question: If a surgeon performs a breast-cyst aspiration and submits the aspirate to patho... Read more
Coding Quiz:
Test Yourself with Crohn's Surgical Case
Identify diagnosis, too. If your surgeon treats a patient with Crohn's disease who has bo... Read more
CCI 24.1:
Don't Stumble on 38573, 45395 Bundles
Know when '0' means 'no.' If you're getting suspicious denials for laparoscopic lymphaden... Read more
Coding Quiz:
Dissect This Crohn's Case for Multiple Procedures
Understand modifier 51 use. You have your answers for coding the Crohn's surgical case de... Read more
EHR Update:
Grasp Fed's New Plan to Overhaul Interoperability
Embrace patient-directed data sharing. According to a recent announcement from CMS, the h... Read more
Reader Question:
Guide Breast Biopsy Choice by Method
Question: Our surgeon performed a "stereotactic needle core biopsy" of breast tissue, remo... Read more
Reader Question:
Beware Stark Self-Referral
Question: If a few surgeons from our practice were to open an outpatient clinic for colono... Read more
Reader Question:
Focus on Observation Discharge
Question: A surgeon in our practice admitted a patient to the hospital for initial observa... Read more
Reader Question:
Pick One Enterolysis Code
Question: The surgeon performed an open limited lysis of adhesions in the abdominal cavity... Read more
You Be the Coder:
Distinguish AIDS, HIV This Way
Question: How do I know when to code for AIDS (B20), not HIV (Z21)? Tennessee Subscriber ... Read more
CPT® 2018:
Update How You Report Deep-Tissue and Facial Pedicle Flaps
Focus on vascular pedicle to choose correct code. If you haven't taken the time to master... Read more
ICD-10:
Follow 4 Tips for Perfect Pressure Ulcer Dx
Look for site, severity, and more. When your surgeon treats pressure ulcers, you'll need ... Read more
E/M Coding:
Bust 4 'Prolonged Service' Coding Myths
Use codes according to published guidelines. If patient care extends beyond the typical t... Read more
Reader Question:
Know Measurement Rules for Melanoma Excision
Question: An op report describes melanoma re-excision of a 1.9 cm lesion with 0.1 cm margi... Read more
Reader Question:
See if History is Present or Past
Question: I'm new to E/M coding, and I'm confused about where the "current" conditions/sym... Read more
You Be the Coder:
Get Up to Speed on Imaging AUC
Question: We recently started using a CDSM module for imaging services in our surgical pra... Read more
CPT® 2018:
Greet New Laparoscopic Peritoneal-Lymphadenectomy Code
38573 encompasses washings, biopsies, and more. Prior to January 1, only an unlisted code... Read more
ICD-10:
Don't Let 'Medical Necessity' Gap Undermine GI Surgery Pay
Focus coding for reported symptoms and final diagnoses. When your general surgeon takes a... Read more
HIPAA:
Ace Your Security Rule Compliance with 3 Tips
Lockdown physical and virtual access. HIPAA enforcement actions are bad news for the reci... Read more
Reader Question:
Check Payer Rules for GERD Procedure
Question: Our surgeon performed a laparoscopic esophageal sphincter augmentation by placin... Read more
Reader Question:
Focus on Details for Lap-Band Adjustment
Question: During an office visit, a surgeon in our practice performed a lap band adjustmen... Read more
Reader Question:
File Claims on Time
Question: We had a problem with a claim and didn't get it filed with Medicare until over a... Read more
You Be the Coder:
Colon Resection Connection Drives Code Choice
Question: I'm trying to code a note titled "partial colectomy," in which the surgeon descr... Read more
CCI Update:
Master Version 24.0 Edits for Your Surgery Practice
Stay compliant with claims-filing rules. With loads of new CPT® codes effective in Janua... Read more
CCI Edits:
Galvanize Bundling Rules with Resources and Documentation
Know your payer's expectations. Although Correct Coding Initiative (CCI) bundles indicate... Read more
ICD-10:
Capture Underlying HIV Condition for Surgical Report
Alert payers to possible complications. When your surgeon performs a procedure on a patie... Read more
HIV Coding Quiz:
Gauge Your Answers Against the Experts'
Report AIDS in narrow circumstances. Making errors when reporting human immunodeficiency ... Read more
Reader Question:
Nail Down Method and Reason for Colonoscopy Code
Question: Our surgeon documented a colonoscopy for a 62-year-old female patient who had a ... Read more
Reader Question:
Get Hemorrhoid Coding Right
Question: The surgeon performed a flexible sigmoidoscopy for a patient who presented with ... Read more
Reader Question:
Check CCI for 2 Scopes
Question: Our surgeon performed a colonoscopy, removing one polyp, but he also documented ... Read more
Reader Question:
Look Ahead to Appropriate Use for Imaging
Question: To comply with the CMS rule about appropriate use for imaging, we recently added... Read more
Reader Question:
List Most Specific Diagnosis
Question: A primary care physician referred a patient suffering from symptoms such as a co... Read more
CPT® 2018:
Update Bone Marrow Sampling With New, Revised Codes
Learn new way to report aspiration and biopsy together. When your surgeon extracts a bone... Read more
ICD-10-CM:
Diagnosis: It's Not Just For Medical Necessity Anymore
Your Dx choice can have 'quality' pay implications. If you think of diagnosis coding as t... Read more
E/M Focus:
Smash 5 Common E/M Coding Myths
Surgical visits may count toward 'established patient' status. You received E/M coding ad... Read more
Reader Question:
Clarify Diverticulosis Coding
Question: We have an op report from a colonoscopy in which the surgeon diagnosed diverticu... Read more
Reader Question:
Solve Catheter Insertion- Replacement- Removal-Mystery
Question: For a 72-year-old male patient, our surgeon removed a non-tunneled central venou... Read more
You Be the Coder:
Beware All-Encompassing Endograft Codes
Question: For a patient with an infrarenal aorta aneurysm that had not ruptured, our surge... Read more
CPT® 2018:
Set Your Vascular Surgery Coding Course for Next Year
Drop some radiology codes for new, comprehensive service descriptors. If your surgeons pe... Read more
CPT® 2018:
Get the Scoop on Observation-Code Clarification
Place of service is key. Beginning Jan. 1, you will find a subtle but important revision ... Read more
Billing:
Find Resolution Options Beyond 'Appeal'
See if you qualify for low volume appeals settlement. If you hate appeals but aren't will... Read more
Reader Question:
Use Pathology Diagnosis for TURP After-Care
Question: Our surgeon performed a TURP procedure. When the patient came in for follow-up c... Read more
Reader Question:
Avoid 'Open' Trap for Bariatric Surgery Repair
Question: We had a patient return with complications following a gastric bypass procedure.... Read more
You Be the Coder:
Don't Overuse Modifier 25
Question: Our surgeon saw a patient in the office who was referred by another physician fo... Read more