Reasonable coders and practitioners can and do disagree about when a separate E/M service is warranted on the day of a minor procedure. This audit … [Read more...]
Surgical procedures, modifiers, and the global package
CMS and CPT both define the components of the global surgical package to include certain pre-op, intra-op, and post-op services. Learn what is included in the single payment, what may be reported separately and how to do it.
Modifier update 2022
Modifier update: 2022 Recorded February 17, 2022 CMS released four new modifiers at the end of 2021, and CPT released one. These include … [Read more...]
Billing for joint injections | Reference Sheet
When doing a joint injection, sometimes a separate E/M service is billed on the same day, and sometimes, it's not. This grid will help you determine … [Read more...]
Lesion Destruction Tip Sheet
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...]
Can we bill an E/M service with a scheduled endoscopy?
Question: Can we charge an E/M service when we do a scheduled endoscopy to account for the cost of nursing staff, supplies, pre- and post- care of … [Read more...]
Coding for Mohs Micrographic Surgery
Mohs surgery is performed to remove complex or ill-defined skin cancer, and the procedure includes both the surgery and histopathologic examination. … [Read more...]
Modifier 51 or 59? How to know which to bill?
Modifier 51 and 59 are both used on second and subsequent surgical procedures, when performed on the day of a primary procedure There are two … [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...]
Shaving of epidermal or dermal lesions
The chart below includes CPT® codes, and descriptions for shaving epidermal and dermal lesions. After the chart, there are important key points to … [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...]
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...]
CPT codes for skin biopsies
Correctly selecting and reporting skin biopsies requires an understanding of CPT codes for skin biopsies There are codes for excision of benign … [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 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 definitions of minor procedures used frequently in primary care and urgent care. And, even more important, instructions for … [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...]
Minor Procedures
These reference sheets for minor procedures include common CPT® codes, descriptions, current work and non-facility RVUs, and global days for quick … [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...]
Can two practices split the post-op office care of a patient?
Question: Can two practices split the post-op office care of a patient? Answer: No. Although the operative and post-operative portions of the … [Read more...]
What does the decision to perform a minor procedure really mean?
I received this question recently and want to share it with you. “Since the decision to perform a minor procedure is included in the payment for the … [Read more...]