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General Surgery Coding Alert

CPT® 2019:
Focus FNA Reports With New 'Guidance-Specific' Codes
Distinguish first and subsequent lesions. The two existing codes your general surgeon rel... Read more
Modifier Quiz:
Check Your Modifier Know-How With These 5 Scenarios
Recall X{EPSU} options. Modifiers can make or break your Medicare claims, so take this op... Read more
Modifier Quiz Answers:
See How Your Modifier Quiz Answers Stack Up
Forget these coding tools and lose pay. Now that you've tried your hand at coding the fiv... Read more
CPT® 2019:
Grab This G-Tube Replacement Opportunity
Make sure to document gastrostomy tract revision. When your general surgeon performs a co... Read more
Reader Question:
Honor Patient PHI Request
Question: Do you have any advice to help us protect our patients' health information, if t... Read more
Reader Question:
Don't Double-Dip 'Diagnostic'
Question: One of our surgeons performed a diagnostic laparoscopy with ovarian cystectomy. ... Read more
Reader Question:
Override CCI Edit for Separate Uterine Adnexa Sites
Question: Our surgeon laparoscopically removed the patient's right ovary and tube, but als... Read more
Reader Question:
Restrict Modifier GT Use
Question: I heard that there was an update about modifier GT but don't understand it. Coul... Read more
You Be the Coder:
Code This PTA Case
Question: For a case involving a peritonsillar abscess (PTA), the surgeon performed an inc... Read more
CPT® 2019:
Look for PICC-Line Updates and More
Know when to bundle imaging services. The only thing constant is change — so get ready ... Read more
Physician Fee Schedule:
Expect Potential E/M Overhaul for 2019
Watch for possible final-rule revisions. CMS has released the proposed Medicare Physician... Read more
Catastrophe Claims:
Follow Special Procedure Coding Rules for Hurricane Michael Victims
Watch for Medicare waivers and modifiers. If you're a general surgery practice operating ... Read more
Reader Question:
Beware Procedure-Code Deletion Date
Question: We had a case that involved a procedure performed in late December that we did n... Read more
Reader Question:
Details Guide Esophageal Code Selection
Question: The surgeon performed an endoscopy with esophagus biopsy for a patient with a di... Read more
Reader Question:
Limit Table-of-Risk to One Component for MDM
Question: The surgeon performed a pre-op visit before hernia surgery, and the patient has ... Read more
You Be the Coder:
Calculate Diameter to Cut Skin Excision Errors
Question: In an op report for a malignant lesion excision from the patient's forearm, the ... Read more
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
Grasp Real Penalty Risk for Privacy Violations
Having a program is not enough. You might think you're safe from enforcement action if yo... 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 a... 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-10-C... 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 qu... 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 t... 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 patient ... 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 informati... 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
Follow Documentation, Definition, Deduction for Diagnosis Code
Wait for pathology report, if possible. When your surgeon performs a procedure that resul... Read more
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 QPP ... 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
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
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
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
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
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
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