tci General Surgery Coding Alert - 2013 Issue 1

Surgery Guidelines: 'Separate Procedure' Designation Limits How You Use Codes

CPT® and Medicare rules agree. When your surgeon uses a code that CPT® identifies with the words "separate procedure," you better check your claim carefully to make sure you won’t face denials. Look to CPT® for Definition CPT® surgery guidelines define separate-procedure codes as services "that are commonly carried out as an integral component of a total service or procedure…" The designation restricts when and how you can report separate-procedure codes with any other related procedures, according to the guidelines. For example: Under most circumstances, you shouldn’t report 44180 (Laparoscopy, surgical, enterolysis [freeing of intestinal...

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