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    Sherryf 17dc663c 835f-46e2-8975-e35223807510 Sherryf 17dc663c 835f-46e2-8975-e35223807510 Presentation Transcript

    • CPT Seminar
      Welcome to Seminar
    • Seminar Ground Rules:
      Rule 1: When you need to ask a question to the instructor, you will raise your hand by placing two ?? After your question. This signals that you have a question for the instructor.
      Example: Student 1: Type Type Type
      Student 2 Type Type Type
      Student 1 Type Type??
      Rule 2: Stay on Topic. If you wish to talk to another student about something, please email him or her after seminar
      If we seem to be getting off track, or too much is going on, I will say: HOLD UP. That is your cue to stop typing so we can refocus.
    • Seminar Ground Rules Continued
      Rule 3: Remember Netiquette. You should respect everyone. Do not use all caps as that means you are shouting.
      Rule 4: Be prepared: In the future, I will sometimes provide reading material such as case studies for you to read or complete before seminar. This information will be placed under the seminar section of each unit.
      Rule 5: Be actively involved in the seminar. In order to receive credit for seminar, you must actively participate and you must arrive on time and stay the entire hour. If you leave early, you will not receive credit.
    • Seminar Option 2:
      If you cannot attend seminar, you may choose the Seminar Option 2
      This option is harder and will be graded harder
      This option requires you to write an essay
      Essay must use proper English grammar
      Responses provide detailed examples
      Must meet length requirements
      No credit will be given for late option two assignments.
    • Surgery Section is the Third Section of the CPT Manual
      Codes begin with 1, 2, 3, 4, 5, or 6
      These are invasive procedures
      Non-invasive procedures would not be in this section. They would be found under the E/M Section
      Majority of Surgery Section is arranged from outside to inside of the body
      5
    • Surgical Package
      Surgical package includes specific details that cannot be coded as separate procedures
      If you code them separately, you would be overcoding and it could be deemed as fraud
      CPT and Medicare have different rules for what is contained in the Surgical Package
      6
    • Separate Procedure Continued
      Appears in parentheses after code description
      Ask yourself if the separate procedure code is an integral part of another procedure
      A modifier such as -59 distinct services should be added to explain
      7
    • Example of Separate Procedure
      Look up code 44820
      Excision of lesion of mesentery (separate procedure)
      Included in code 44800 Excision of Meckel’s diverticulectomy or omphalomesenteric duct
      Would not use code 44820 unless it was done by itself.
    • Integumentary System
    • Four Rules For Coding Repairs
      Rule 1: Repairs must be measured and reported in centimeters
      Rule 2: Multiple wounds within the same location given in the description of the code should be added together and reported
      10
    • You Code It
      A child is seen in the physician’s office for a superficial laceration of the right knee. The physician repairs the 3.0 cm laceration with simple suturing
      Answer: 12002 Simple repair of superficial wounds of scalp, neck, axillae, external genitalia, trunk and/or extremities (including hands and feet) 2.6 to 7.5 cm.
    • Rule Three:
      Debridement and Contamination are a part of the global service. Can’t code separately except:
      Prolonged cleansing
      Above average tissue amount is removed
      Carried out separately
      12
    • Rule 4: Involvement of Nerves, Blood Vessels and Tendons
      When any nerve, blood vessel, or tendon is repaired, the code from the Nervous, Cardiovascular, or Musoskeletal System should be used instead of the Integumentary.
      One exception: When the physician performs a complex repair in addition to repairing the nerve ect., You can code repair
      13
    • Coding Example
      Repair of cardiac wound would be:
      33300 Repair of cardiac wound; without bypass
      This code is found under Cardiovascular System and not Integumentary System
    • Musculoskeletal System
    • Casts and Strapping
      Do not code for the initial cast or strapping
      Codes between 2000-28889 include the application and removal of the first cast or traction device
      Using an additional code from the 2900 series would be incorrect
      16
    • Coding Example
      Closed reduction of proximal humerus fracture, right
      23605 Closed treatment of proximal humeral (surgical or anatomical neck) fracture; with manipulation with or without skeletal traction
    • Endoscopy
      Endoscopy means “looking within”.
      Codes are categorized by body part and then by type of endoscopy: surgical or diagnostic
      Surgical always includes diagnostic and should not be coded separately
    • Respiratory System
    • Bilateral versus Unilateral Procedures
      Procedures are unilateral. When the services are not meant to be unilateral, the code will tell you.
      If you are using a code that does not say anything about being bilateral, and you provide a service that is done on both sides, you will use a modifier -50 Bilateral Services on the second side
      20
    • Coding Example
      Bilateral nasal endoscopy with total ethmoidectomy
      31255-50
    • Modifiers
      Add details to codes
      A list can be found in Appendix A
      Some apply only to hospitals
      Others apply to physician services
      You must learn these-memorize them!
    • This Week: Sept 13- Sept 19
      Proctor Form is Due
      Drop in Proctor Drop Box on Course Home. Instructions and Form can be found under doc sharing
      Karen Kuharic is the proctor at SCCC/ATS. She is in Room 102 and her number is 620 417 1105
      Assignment
      Discussion
      No Seminar on Sept 20th
    • Questions???
      Copyright ©2005 by Thomson Delmar Learning. ALL RIGHTS RESERVED.
      2-24