"General Surgery" Articles

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December 22nd, 2020

ICD-10-CM 2021 Codes for your Specialty

By Christine Woolstenhulme, QCC, QMCS, CPC, CMRS | Published December 22nd, 2020

13. Diseases of the musculoskeletal system and connective tissue (M00-M99) Code: Description:M05.7A Rheumatoid arthritis with rheumatoid factor of other specified site without organ or systems involvementM05.8A Other rheumatoid arthritis with rheumatoid factor of other specified siteM06.0A ...

December 22nd, 2020

ICD-10-CM 2021 Codes for your Specialty

By Christine Woolstenhulme, QCC, QMCS, CPC, CMRS | Published December 22nd, 2020

19. Injury, poisoning and certain other consequences of external causes (S00-T88) Code: Description:S20.213A Contusion of bilateral front wall of thorax, initial encounterS20.213D Contusion of bilateral front wall of thorax, subsequent encounterS20.213S Contusion of bilateral front wall of thorax, sequelaS20.214A Contusion of ...

December 22nd, 2020

ICD-10-CM 2021 Codes for your Specialty

By Christine Woolstenhulme, QCC, QMCS, CPC, CMRS | Published December 22nd, 2020

20. External causes of morbidity (V00-Y99) Code: Description:V00.031A Pedestrian on foot injured in collision with rider of standing electric scooter, initial encounterV00.031D Pedestrian on foot injured in collision with rider of standing electric scooter, subsequent encounterV00.031S Pedestrian on foot injured ...

December 22nd, 2020

ICD-10-CM 2021 Codes for your Specialty

By Christine Woolstenhulme, QCC, QMCS, CPC, CMRS | Published December 22nd, 2020

11. Diseases of the digestive system (K00-K95) Code: Description:K20.80 Other esophagitis without bleedingK20.81 Other esophagitis with bleedingK20.90 Esophagitis, unspecified without bleedingK20.91 Esophagitis, unspecified with bleedingK21.00 Gastro-esophageal reflux disease with esophagitis, ...

October 28th, 2020

Incident To

By Christine Woolstenhulme, QCC, QMCS, CPC, CMRS | Published October 28th, 2020

Just about any large clinic you visit will have non-physician practitioners, or NPPs. These will include physician assistants, nurse practitioners, and clinical nurses for example. Practices and clinics can bill under the NPPs if they are credentialed with the payer, but the reimbursement is only 85% of the fee schedule. There ...

August 10th, 2020

Coding Injections for Pain Management

By Christine Woolstenhulme, QCC, QMCS, CPC, CMRS | Published August 10th, 2020

Coding for pain management can get confusing. How many injections, the location, and when to use a modifier are all common questions. This article will cover some of the most common injections used in pain management. Trigger Point Injections Trigger point injections are reported by how many muscles are treated using an ...

August 10th, 2020

Modifier 50 — Four "Must Know" Tips For Getting Paid

By Aimee Wilcox, CPMA, CCS-P, CST, MA, MT, Director of Content | Published August 10th, 2020

Modifiers added to an HCPCS or CPT© code alters the code description, providing clarity about the service for proper claim processing and reimbursement. Here are four things you must know about modifier 50 to ensure proper payment. - Modifiers are either informational or payment related. Informational modifiers provide additional...

July 14th, 2020

Are NCCI Edits and Modifiers Just for Medicare?

By Christine Woolstenhulme, QCC, QMCS, CPC, CMRS | Published July 14th, 2020

The National Correct Coding Initiative (NCCI) edits were developed by CMS to help promote proper coding and control improper coding that leads to incorrect payments with part B claims. It is important to understand that NCCI edits do not include every possible code combination or every type of un-bundling combination. With that ...

March 5th, 2020

Who Qualifies for Chronic Care Management Services

By Christine Woolstenhulme, QCC, QMCS, CPC, CMRS | Published March 5th, 2020

Per MLN Chronic Care Management Services, the following patients are eligible: "Patients with multiple (two or more) chronic conditions expected to last at least 12 months or until the death of the patient, and that place the patient at significant risk of death, acute exacerbation/decompensation, or functional decline, are eligible for CCM services." Examples of chronic conditions ...

February 10th, 2020

A 2020 Radiology Coding Change You Need To Know

By Aimee Wilcox, CPMA, CCS-P, CST, MA, MT, Director of Content | Published February 10th, 2020

The radiology section of the 2020 CPT© has 1 new, 18 revised, and 14 deleted codes. Interestingly, six of the 14 deleted codes were specific to reporting single-photon computerized tomographic (SPECT) imaging services of the brain, heart, liver, bladder, and others. If your organization reports radiology services, it is...

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October 1st, 2019

Do ICD-10 Updates Have Your Heart Beating Irregularly? Check Out the New Atrial Fibrillation Codes

By Aimee Wilcox, CPMA, CCS-P, CST, MA, MT, Director of Content | Published October 1st, 2019

Atrial fibrillation (AF) is the most common type of abnormal heart rhythm (arrhythmia). It is caused by a disorder in the heart’s electrical system. AF is the result of abnormal contractions of the atria (upper two chambers of the heart) causing them to quiver and beat out of sync with ...

August 16th, 2019

Medical ID Theft

By Namas | Published August 16th, 2019 - Last Review/Update August 20th, 2019

Medical ID Theft "So, do you guys think you can do something with that?" John asked angrily at our first meeting with him in August 2017 as he slammed a stack of medical bills, EOBs and collection letters - three inches high - down in front of my partner and I. ...

August 9th, 2019

The OIG Work Plan: What Is It and Why Should I Care?

By Namas | Published August 9th, 2019 - Last Review/Update August 14th, 2019

The Department of Health and Human Services (HHS) founded its Office of Inspector General (OIG) in 1976 and tasked it with the responsibility to combat waste, fraud, and abuse within Medicare, Medicaid, and the other HHS programs. With approximately 1,600 employees, HHS OIG is the largest inspector general's office within ...

July 19th, 2019

The Facts of Critical Care

By Namas | Published July 19th, 2019 - Last Review/Update July 30th, 2019

Critical care services remain to not only be an area of confusion for providers, coders, and auditors, but also a constant target for the carriers for audit. We can sit back and look at critical care and think of all of the ways the code descriptor and/or use could be ...

July 12th, 2019

5 Ways to Minimize HIPAA Liabilities

By BC Advantage | Published July 12th, 2019 - Last Review/Update July 30th, 2019

Last year was historic for HIPAA enforcement. The HHS Office of Civil Rights collected a record $23.5 million in settlements and judgments against providers guilty of HIPAA violations. To avoid becoming part of that unwanted statistic, it’s important to pay extra close attention to five key areas of HIPAA vulnerability. Take ...

May 31st, 2019

Auditing Hospitalist Services

By Namas | Published May 31st, 2019 - Last Review/Update June 4th, 2019

Auditing Hospitalist Services The inpatient side of coding and auditing can be enormously complex, with many more moving parts than are typically found in the outpatient setting. In this audit tip, we will discuss a few of the challenges that come with auditing one of the most important players in the ...

April 23rd, 2019

Coverage for Hearing Aids and Auditory Implants

By Brandon Dee Leavitt QCC, CMCS, CPC, EMT | Published April 23rd, 2019

For hearing impairment, Medicare is firm in its stance on when it will and will not cover hearing correction. In the PUB 100-02 Medicare Benefit Policy Manual, Chapter 16, Medicare cites the Social Security Act by explaining: "..."hearing aids or examination for the purpose of prescribing, fitting, or changing hearing aids" ...

March 18th, 2019

How to Report Imaging (X-Rays) of the Thumb

By Aimee Wilcox, CPMA, CCS-P, CST, MA, MT, Director of Content | Published March 18th, 2019

If you've ever taken piano lessons, you know that the thumb is considered the first finger of the hand. Anatomically, it is also referred to as the first phalanx (finger). However, when you are coding an x-ray of the thumb, images are captured of the thumb, hand, wrist, and all ...

January 4th, 2019

Nine New Codes for Fine Needle Aspirations (FNA) in 2019

By Aimee Wilcox, CPMA, CCS-P, CST, MA, MT, Director of Content | Published January 4th, 2019

If your practice performs a lot of fine needle aspirations (FNA), you probably have the code options memorized (10021 without image guidance and 10022 with image guidance). However, the 2019 CPT codes now include nine (9) new FNA codes (10004-10012), one deleted FNA code (10022) and one revised FNA code ...

October 17th, 2018

Wolters Kluwer Drug Pricing

By Find-A-Code | Published October 17th, 2018

Wolters Kluwer provides unit and package pricing for multiple drug price types: Average Wholesale Price (AWP), Wholesale Acquisition Cost (WAC), Direct Price (DP), Manufacturer's Suggested Wholesale Price (SWP), Centers for Medicare & Medicaid Services, Federal Upper Limit (CMS FUL), Average Average Wholesale Price (AAWP), Generic Equivalent Average Price (GEAP). Average...

July 9th, 2018

Documentation: Face to Face for Home Health Certification

By Christine Woolstenhulme, QCC, QMCS, CPC, CMRS | Published July 9th, 2018

As a physician, you are responsible for providing appropriate, accurate supporting documentation of your face-to-face encounters (FTF) with your patients regarding home health care. Analysis of the recent errors identified by the Comprehensive Error Rate Testing (CERT) Review Contractor shows a continuing increase in denials related to documentation for the FTF. The ...

March 26th, 2018

Q/A: Which Modifiers to Use When Billing 44005 and 36556 Together

By Chris Woolstenhulme QCC, CMCS, CPC, CMRS | Published March 26th, 2018 - Last Review/Update April 11th, 2018

I have a denial for 44005 and 36556 being billed together. I added modifiers 51, 59, and Q6 to 36556 but I am afraid it will deny again?

March 9th, 2018

Documentation for Ordering Oxygen Supplies and Equipment

By Medicare Learning Network | Published March 9th, 2018 - Last Review/Update March 26th, 2018

The Medicare Learning Network provides guidance on required documentation for Ordering Oxygen Supplies and Equipment.

March 8th, 2018

Documentation for Manual Wheelchairs

By Medicare Learning Network | Published March 8th, 2018 - Last Review/Update March 15th, 2018

The Medicare Learning network provides guidance on how to prevent denials for Manual Wheelchair Bases....

March 8th, 2018

Documentation for Home Health Services (Part A non DRG)

By Medicare Learning Network | Published March 8th, 2018 - Last Review/Update March 27th, 2018

The Medical Learning Network provides coverage guidance, which should be documented, for home health services.

March 8th, 2018

Documentation and Orders for Respiratory Assistive Device

By Medicare Learning Network | Published March 8th, 2018 - Last Review/Update March 27th, 2018

The Medicare Learning Network provides guidance on required documentation for a respiratory assistive device and ordering guidelines.

January 31st, 2018

Influenza, Are You Billing Correctly?

By Christine Woolstenhulme, QCC, QMCS, CPC, CMRS | Published January 31st, 2018

With this year's Flu season being the most widespread on record, providers are seeing more patients and giving more immunizations for influenza than normal. Here are a few things to keep in mind during this flu season. Know the rules with your payers to ensure proper reimbursement and correct billing. For example, did you ...

December 18th, 2017

Accreditation and Billing for Office Based Surgery (OBS)

By Christine Woolstenhulme, QCC, QMCS, CPC, CMRS | Published December 18th, 2017

The traditional healthcare has seen many changes over the years, one of the newest changes we are seeing is procedures once being done as an inpatient, then as an outpatient and now from the outpatient facility to Office-Based procedures. For an Office or Provider to be eligible to perform Office-Based Surgery the ...

September 20th, 2017

Bladder/Urothelial Tumor Markers (Jurisdiction F)

By Christine Woolstenhulme, QCC, QMCS, CPC, CMRS | Published September 20th, 2017

CMS recently released a new LCD for Jurisdiction F, Bladder/Urothelial Tumor Markers (L36680). Documentation Requirements The medical record must clearly identify the number and frequency of bladder marker testing. Medical record documentation must be legible, must be maintained in the patient’s medical record (hard copy or electronic copy), and must meet the ...

September 8th, 2017

Global Surgical Package: When to Bill and When Not to Bill, that is the Question

By Stephanie Allard, CPC, CEMA, RHIT | Published September 8th, 2017 - Last Review/Update January 31st, 2018

The global surgical package is inclusive of the services that would normally be provided to the patient following surgery. Depending on the global period assigned to a CPT code, the pre-operative, intra-operative and post-operative services could be included in the global surgical package.....

September 1st, 2017

Preventive Services: Cardiovascular Disease Screening Tests

By Find-A-Code | Published September 1st, 2017 - Last Review/Update February 2nd, 2018

The following information from the Medicare Learning Network provides guidance from the Department of Health and Human Services on Cardiovascular Disease Screening Tests: 80061 - Lipid panel, this panel must include the following: 82465 - Cholesterol, serum, total 83718 - Lipoprotein, direct measurement, high density cholesterol (HDL cholesterol) 84478 - Triglycerides Z13.6 All Medicare beneficiaries without apparent signs or symptoms ...

August 1st, 2017

How to Bill a Dressing Change

By Christine Woolstenhulme, QCC, QMCS, CPC, CMRS | Published August 1st, 2017

A dressing change may not be billed as either a debridement or other wound care service under any circumstance (e.g., CPT 97597, 97598, 97602). Medicare does not separately reimburse for dressing changes or patient/caregiver training in the care of the wound. These services are reimbursed as part of a billable procedure code that, commonly but not necessarily, ...

March 28th, 2017

Respiratory Assist Devices (RAD) E0470 and E0471 - Billing Reminders

By Christine Woolstenhulme, QCC, QMCS, CPC, CMRS | Published March 28th, 2017 - Last Review/Update July 28th, 2017

Add the KX modifier to all claims for RADs and accessories for the first through third months if all thecoverage criteria have been met. Add the KX modifier to all claims for the fourth month and thereafter if all the coverage criteria have been met and if the physician signed and dated a ...

March 20th, 2017

Acute Postoperative Pain Management

By Wyn Stahel | Published March 20th, 2017

Caution needs to be observed when reporting post-operative pain management (POPM). In accordance with NCCI edits policies, postoperative pain management is considered bundled in the surgical code(s). There are only a few instances where it may be billed separately. Medicare Global Surgery Rules prevent separate payment for postoperative pain management when ...

February 27th, 2017

Documentation: Face to Face for Home Health Certification

By Christine Woolstenhulme, QCC, QMCS, CPC, CMRS | Published February 27th, 2017 - Last Review/Update August 16th, 2017

January 6th, 2017

Assistant-At-Surgery Services

By Brittney Murdock, QCC, CMCS, CPC | Published January 6th, 2017

An "assistant at surgery" is a physician who actively assists the physician in charge of a case in performing a surgical procedure. The "assistant at surgery" provides more than just ancillary services. Codes eligible for reimbursement for an assistant surgeon are designated by the Centers for Medicare and Medicaid Services (CMS) ...

March 29th, 2016

PQRS Measures by Specialty (2016)

By InstaCode Institute | Published March 29th, 2016

Download CMS's Preferred PQRS Measures Lists by Specialty. 17 Specialties to choose from. Find out exactly what CMS is expecting to see reported for your specialty.

January 6th, 2016

Minor Surgical Procedures - How to document and bill

By Codapedia | Published January 6th, 2016

When performing minor surgical procedures, it is important to document what was done, how it was done, where it was done, why it was done, how deep, how long, and how many. In billing and reporting a procedure, document in the medical record the key components...

January 6th, 2016

Pre-op visits: True or False?

By Codapedia | Published January 6th, 2016

Are the following statements true or false? • The PCP cannot be paid to do a pre-op assessment of a Medicare patient prior to surgery because of the new consult rules. • The surgeon can never be paid to do a pre-op visit if s/he...

May 11th, 2015

How To Report Co-Surgeons and Assistant Surgeon Modifiers

By Aimee Wilcox, CPMA, CCS-P, CST, MA, MT, Director of Content | Published May 11th, 2015 - Last Review/Update January 30th, 2017

Some surgeries require the expertise of more than one surgeon or may require the assistance of another surgeon to ensure adequate care is given and the surgery is a success. Let's review a couple terms: Co-Surgeon: When two surgeons act as primary surgeon for a specific procedure. Each acts as the primary surgeon ...

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"General Surgery" Articles

ICD-10-CM 2021 Codes for your Specialty

ICD-10-CM 2021 Codes for your Specialty

ICD-10-CM 2021 Codes for your Specialty

ICD-10-CM 2021 Codes for your Specialty

Incident To

Coding Injections for Pain Management

Modifier 50 — Four "Must Know" Tips For Getting Paid

Are NCCI Edits and Modifiers Just for Medicare?

Who Qualifies for Chronic Care Management Services

A 2020 Radiology Coding Change You Need To Know

Do ICD-10 Updates Have Your Heart Beating Irregularly? Check Out the New Atrial Fibrillation Codes

Medical ID Theft

The OIG Work Plan: What Is It and Why Should I Care?

The Facts of Critical Care

5 Ways to Minimize HIPAA Liabilities

Auditing Hospitalist Services

Coverage for Hearing Aids and Auditory Implants

How to Report Imaging (X-Rays) of the Thumb

Nine New Codes for Fine Needle Aspirations (FNA) in 2019

Wolters Kluwer Drug Pricing

Documentation: Face to Face for Home Health Certification

Q/A: Which Modifiers to Use When Billing 44005 and 36556 Together

Documentation for Ordering Oxygen Supplies and Equipment

Documentation for Manual Wheelchairs

Documentation for Home Health Services (Part A non DRG)

Documentation and Orders for Respiratory Assistive Device

Influenza, Are You Billing Correctly?

Accreditation and Billing for Office Based Surgery (OBS)

Bladder/Urothelial Tumor Markers (Jurisdiction F)

Global Surgical Package: When to Bill and When Not to Bill, that is the Question

Preventive Services: Cardiovascular Disease Screening Tests

How to Bill a Dressing Change

Respiratory Assist Devices (RAD) E0470 and E0471 - Billing Reminders

Acute Postoperative Pain Management

Documentation: Face to Face for Home Health Certification

Assistant-At-Surgery Services

PQRS Measures by Specialty (2016)

Minor Surgical Procedures - How to document and bill

Pre-op visits: True or False?

How To Report Co-Surgeons and Assistant Surgeon Modifiers

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contact

article topics