CPT® does not make it easy to locate codes for destruction of lesion(s). These codes are found in multiple chapters throughout the CPT® book, and are … [Read more...]
Surgical Coding for Hernia Repair
An abdominal hernia is a protrusion of part of the intestines through a weakened section of the abdominal cavity; herniations can occur in other parts … [Read more...]
Procedure Coding for Colonoscopies
“A colonoscopy is the examination of the entire colon, from the rectum to the cecum, and may include the examination of the terminal ileum or small … [Read more...]
Coding for breast procedures: biopsy, localization devices, and surgery
From biopsy to localization device to mastectomy, coding for breast procedures can be challenging. This article summarizes the rules related to these … [Read more...]
E/M frequency data for surgical specialties
CMS releases E/M frequency data annually. A physician self-elects their specialty designation when enrolling with Medicare. Unfortunately, there … [Read more...]
Repair (closure) CPT® 12001–13160–2020 update
Laceration or wound repair codes are reported based on the type of repair (simple, intermediate, complex), the anatomic location, and the length … [Read more...]
Modifier 51 or 59? How to know which to bill?
There are two modifiers commonly used in surgical specialties when billing two or more procedures at the same encounter. Appending the correct … [Read more...]
Coding multiple procedures | Examples with modifiers
Biopsies and lesion destruction codes are often performed at the same patient visit. This leads to questions about bundling and modifiers. There are … [Read more...]
Coding for destruction of malignant lesions
The primary factors in selecting a code for destruction of malignant lesions are: Size of lesion (not defect) Location Method is not a … [Read more...]
Diagnosis coding for biopsy sent for pathology
Question: What diagnosis code should you use when sending a skin biopsy to pathology? a) D48.5 Neoplasm of uncertain behavior of skin, or b) … [Read more...]
CPT® codes for fine needle aspiration
Fine needle aspiration biopsy Material is aspirated with a fine needle and the cells are examined cytologically Core needle biopsy is … [Read more...]
Codes for skin biopsies
CPT updated certain skin biopsy codes in 2019 The codes for excision of benign and malignant lesions did not change, and codes for shave biopsies … [Read more...]
Using Modifier 59 | Quick Reference
Modifier 59 is referred to by CMS as the modifier of last resort. It is often used when modifier 51 is the more accurate modifier. This quick … [Read more...]
Using Modifier 33 | Quick Reference
Modifier 33 is a CPT modifier used to identify medical care whose primary purpose is delivery of an evidence based service, based on recommendations … [Read more...]
Using Modifier 25 | Quick Reference
Use of Modifier 25 may be applicable when an E/M service is provided on the same day as a procedure, a preventive medicine service, or other medical … [Read more...]
Coding Guide – Minor Surgical Procedures
This guide includes complete definitions, RVUs, and global days of minor procedures used frequently in primary care and urgent care. And, even more … [Read more...]
Are subsequent hospital or office visits prior to surgery billable?
Question: Are the surgeon’s subsequent hospital visits or office visits between their original consult and the final visit prior to surgery … [Read more...]
ICD-10 coding for suspected cancer
Diagnosis coding for possible malignancy How would you feel if your primary care physician and your general surgeon told you—and told your insurance … [Read more...]
Not all emergency surgery should be coded at the highest level | E/M Services and MDM
Surgeons sometimes think that the E/M service on the date of every emergency surgery is the highest level E/M. 99285 or 99223. This article … [Read more...]
Coding for biopsy | Should we wait for a pathology report?
Question: Should we always wait for the pathology report before submitting a code for a biopsy? Answer: Sometimes. Wait for the pathology … [Read more...]