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.
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
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
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