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Surgical Coders: Don’t Overstate Debridement

Tip: This encounter involves topical applications and patient care instruction in addition to removing devitalized tissue.

Question: When the surgeon performs a wound VAC or cleans a wound by scraping with a sharp curette (not excising tissue), is it appropriate to use a debridement code or should we report an active wound care management code from the range 97597-97606?

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Answer: Physicians typically use the debridement codes (11000-11001, Debridement of extensive eczematous or infected skin; … or 11004-11005, Debridement of skin, subcutaneous tissue, muscle and fascia for necrotizing soft tissue infection; …) for debridement by any method.

Without…

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Stay Alert: Modifier 57 Isn’t for Consults Only

Even though Medicare no longer accepts consult codes, you can still apply modifier 57.

Question: In our ob-gyn office, we used to apply modifier 57 to inpatient consult codes. Now that Medicare doesn’t accept consult codes, how should we use

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Surgical Modifiers: Protect Yourself From Instant ‘PC’ Claim Denials

Don’t let ‘wrong surgery’ modifier mistakes stall your reimbursement.

You use modifier TC for the technical component of a test. So logically, you should use modifier PC for the professional component, right? Wrong. But many coders are making that mistake…

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Achieve Modifier 25 Success in Just 3 Easy Steps

Are you a 'gold star' ASC coder?

Understand ‘significant’ and ‘separate’ to earn a gold star.

Knowing when to report modifiers and choosing the best one for each situation can be an easy trip-up for coders. If you find yourself especially befuddled…

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Stay in the Game With the Correct Ligament Repair, Reconstruction Codes

Remember ligament repair abbreviations to simplify elbow ligament surgeries.

Baseball players are gearing up for the season, which means your orthopedist could see a sudden increase in elbow ligament injuries. If conservative therapies fail to help torn medial (841.1) or…

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Factor Location and Depth into Foreign-Body Removals

Explore these three “what if” scenarios to perfect your FBR claims.
Your foreign-body removal (FBR) coding can vary greatly depending on the type of foreign body, its anatomic location, and the depth from which the physician must remove it. Here are three case studies to help you find your way.
Case 1: No Incision Means No Separate […]

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  3. Burn Coding: Calculate Total Body Surface Area (TBSA)Investigate your physician’s documentation to determine the body area percentage…
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8 Simple Steps Organize Your Op Note Coding

This aspect of op note coding is the “horse that pulls the cart.”
Stuck on how to tackle this op note or those sitting on your desk? Follow this advice, provided by Melanie Witt, RN, CPC, COBGC, MA, an ob-gyn coding expert based in Guadalupita, N.M. and co-presenter of the “Ob-Gyn Op Notes” session at the […]

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  3. Op Note Coding Clinic: Breast Reconstruction with AlloDermSurgeons now commonly use AlloDerm in a variety of surgeries,…
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Surgery Coding Challenge: Master Microsurgery Units With This Advice

Check your EOB to make sure payers don’t apply a multiple-procedure reduction to +69990.
Question: When my ENT uses a microscope during a procedure, what guidelines can I use for choosing between 92504 and +69990? Is there a rule governing how many times you can report the add-on code 69990?
Answer…
You can use 92504 (Binocular microscopy [separate […]

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Time Your Surgical Collections Right by Referencing Payer Contracts

Find out if you’re legal in collecting patient portion before providing the surgical service.
Don’t be too hasty in collecting a patient’s copay and deductible up front.
“While in theory, the practice of collecting deductibles up front may sound good, you should check your carrier contracts to be sure you are allowed to do this before requesting […]

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Second Surgery Coding: Tips for Modifier 58, 78 Success

Don’t let ‘unplanned’ lead to ‘unpaid.’
The next time a patient takes an extra trip to the operating room, don’t let the added service throw your coding off track. Keep these tips in mind to know when to assign modifier 78 – or something else.
Check for Surprise Versus Planned
Two modifiers pertain to follow-up trips to the […]

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Surgical Coding: Scar Revision on Previous Mastectomy Site

Tip: Find mastectomy scar revision in wound repair
Question: Our surgeon performed a scar revision on the site of a previous mastectomy. The procedure involved excising a 16.5 cm curved scar before performing a layered closure. How should we code this?
Answer: You should use complex wound repair codes for the scar revision procedure that you describe. […]

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Surgical Coding Mysteries: The Case of the Separate Mesh

Beware Separate Mesh Removal
Question: The surgeon performed the following: Made 10 cm supraumbilical transverse incision with 15-blade scalpel carried down through subcutaneous tissue using Bovie. Used combination electrocautery and blunted dissection to isolate area of scar tissue on patient’s right side. Noted sutures from previous umbilical hernia repair and mesh from right-lower abdominal hernia repair.
Excised […]

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