tci Outpatient Facility Coding Alert - 2016 Issue 10

Scopes: Become an Expert in Coding Multiple Scopes

Have you mastered the art of applying the multiple scope rule yet? The basics: When your orthopedic surgeon performs a knee arthroscopy along with several other procedures, you’ll need to know which procedures to actually claim and how to prioritize them. Read on to master the specifics of this rule. Get the Basics Right What it means: With the help of the multiple-endoscopy rule, Medicare aims to save on costs, by reimbursing only a part of the arthroscopy procedure the provider performs simultaneously as another scope of the same basic type. In other words, under the multiple-scope rule...

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