Finding the right code for lesion destruction is not easy. The codes are distributed in the CPT® book in the integumentary, digestive, male genital system, female genital system, and eye and ocular systems. Some of the codes are selected by the method of destruction and some are not. Some of the codes are selected based […]
Specialty Pages
Coding for every specialty is different. For some specialties, you’ll find the in-depth knowledge and specific coding information you need to accurately and compliantly submit claims. Whether you prefer reading articles, downloading reference sheets and coding guides or watching a webinar, CodingIntel has what you need.
Pessary Billing and Coding
Coding for Pessary Services Primary care practices, gynecology and urology practices often prescribe and provide pessaries. Â A pessary is used to treat pelvic organ prolapse and for urinary incontinence. It provides support for the vaginal walls or uterus. A physician or non-physician practitioner (NPP) must first see the patient, take a history, examine the patient […]
Billing for Multiple Surgical Procedures
When billing for multiple procedures on the same day, use this step by step procedure to determine if you should bill for more than one procedure, and if so, if you should use modifier 51 or modifier 59. It is critical to have access to National Correct Coding Initiative ((NCCI) edits in your software program. […]
Modifier 95, 93: Telemedicine
CPT® has two modifiers for telemedicine. CMS and private payers regularly change their instructions about using these modifiers and what place of service to use. Modifier 95 is for use with real-time, audio/visual visits. Modifier 93 is for audio-only telehealth services Modifier 93: Synchronous Telemedicine Service Rendered Via Telephone or Other Real-Time Interactive Audio-only Telecommunication […]
Wound Care | CPT® Codes for Debridement
Health care organizations have started wound care clinics to care for patients with non-healing wounds and frequently use wound care debridement codes to report the services The care of a post-op wound is done by the surgeon in the global period, and is not separately paid, unless it is on-going and must be referred to […]
Modifier 57
Decision for Surgery. An evaluation and management service that resulted in the initial decision to perform the surgery may be identified by adding modifier 57 to the appropriate level of E/M service. The payment for major surgery includes E/M services provided on the day of and the day before a major surgical procedure, unless it […]
Modifier 24
Understanding E/M modifiers is important for both revenue and compliance. Failing to apply the correct modifier reduces revenue. Applying the wrong modifier or using it when it is not accurate is a compliance issue and puts the practice at risk for payback and disclosures. For additional information, see the article on Global Surgical Package. Modifier […]
Moderate or High MDM – General Surgery
ARCHIVE The 1995/1997 Documentation Guidelines are gone beginning 1-1-2023. (Ding dong….) However, we will still need to use them when auditing notes from before 2023. This article does not apply to services performed after 1-1-2023. Examples of Moderate MDM: Codes: Consult, 99244, Initial hospital 99222, Initial OBS 99219, 99235, ED 99284 Patient presents with a […]
Coding Guide – Global Surgery
This guide from CodingIntel explains surgery coding guidelines and the global period for procedures, and includes the contents of our original CPT® and HCPCS Modifier Guide.
Billing Admission and Subsequent Visits for Patient Having Surgery
What if I admit a patient and don’t take the patient immediately to surgery? Can I bill for the admission and subsequent visits if the patient goes to surgery later in the week? In this case it depends on when you admit the patient and when you decide to take the patient to surgery. A […]
Excision of Soft Tissue, Lipoma Removal
This chart is a quick reference for soft tissue excision. It includes anatomic location and size for subcutaneous and subfacial excisions.
Excision of Benign or Malignant Lesions
This article reviews codes and guidelines for excision of skin lesions. For more information about minor procedures, see additional resources at the bottom of this page. This article includes: CPT® codes for excision Excision of benign lesions Excision of malignant lesions Excision of soft tumors Reporting Excision of Multiple Lesions of the Same Size Coding […]
Surgical Modifiers
This article includes: Surgical modifiers with definitions Guidelines for billing multiple surgical procedures Modifiers in the post-op period Avoiding CPT® modifier mishaps Citations Members can also download the Global Surgery Coding Guide. Some of the information in this article and in the billing guide is the same. Billing for Surgical Services Before submitting a claim […]
Critical Care for General Surgery and Trauma Surgeons
Critical care provided as a stand alone service is based on the seriousness of the patient, the types of interventions, and time. Critical care provided by a surgeon to a patient in a global period for procedures with a 10 or 90 day global period, must also follow the rules for critical care, with the […]
Can I Get Paid for…My Nurse Doing Ear Lavage
The nurse flushed the patient’s ear so I could examine the TM. Free or Fee? Find out more about billing for ear lavage done by nursing staff in this brief video. Back to list Relevant Search Terms: 69209, 69210, cerumen, removal, irrigation, ​
Can I Get Paid for…Evaluation Prior to Surgery
The surgeon evaluates a patient, and determines that surgery is needed. Can the surgeon get paid for this initial service? Watch this short video about billing for evaluation prior to surgery. See also modifier 57. Back to list Relevant Search Terms: modifier 57, global surgical package, global surgery
Coding for Screening Colonoscopy
An Overview of Colonoscopy Coding Guidelines The ACA, which was passed in 2010, did a great many things, but this is what is relevant for colonoscopies: insurers must cover preventive services, like screenings and vaccines, without charging co-pays, deductibles, or coinsurance to encourage early detection and preventive care. A screening colonoscopy should have no patient […]
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