American College Of Surgeons - Inspiring Quality: Highest Standards, Better Outcomes

2018 Mastering General Surgery CPT© Coding

Who Should Attend This Course

General Surgeons

Getting paid is a team effort—and surgeons lead the team. If the doctors don’t understand what’s needed in an operative report from a coding and reimbursement point of view (something they don’t teach in residency) they are shortchanging themselves.

Practice Administrators and Managers

You are the chief compliance officer in most private practices. In order to supervise the economic engine of the practice, you must understand the business office operations.

Coders and Billers

If you’re responsible for entering data, working denials, applying modifiers, posting payments, and filing appeals, your expertise in surgical and office coding must be exacting in its execution!

Hospital or MSO Executives Running General Surgery Practices

Maximize your profits! Understand what is special and unique about billing for the general surgery service line, and keep your surgeons happy and bonus-able. (Not to mention reduce compliance headaches.) Learn the rules and avoid using incorrect and expensive assumptions that result in fiscal disaster.

Register now!

Learning Objectives

As a result of this course participants will be able to:

  • Correctly code common general surgery procedures including breast, endoscopy, colorectal, bariatric, trauma, gall bladder, liver, hernia, and more.
  • Accurately use new and revised incompetent vein treatment codes.
  • Identify areas for improvement in surgical documentation.
  • Accurately apply modifiers when they are required and understand their impact on reimbursement.
  • Understand how to report and get paid for unlisted procedures.
  • Integrate 2018 CPT and HCPCS coding changes and guidelines into practice.

What’s On the Agenda

The Global Surgical Package

  • What’s included in the global package and what can be separately reported?
  • Deconstructing the global payment: surgical splits, RVUs and physician time

Surgeon Role Modifiers

  • Co-surgery vs. Assistant: Are you reporting these correctly?
  • Payor expectations for co-surgery and assistant t surgery documentation.
  • Reimbursement: Difference between co- and assistant surgeon

Same-Day Procedure Modifiers

  • Modifier 22: What justifies modifier 22 and how to increase your changes of payment.
  • Modifier 50: Which procedures accept a bilateral modifier
  • Modifier 52 vs 53: What is the difference and how are they used in general surgery
  • Modifier 51 vs 59: how do you know which one to use? How does reimbursement differ for each
  • Modifiers XE, XP, XS, XU: When to use as an alternative to modifier 59

Modifiers for Additional Procedures Performed during the Global Surgical Period

  • Modifier 58: Documenting stages procedures. Do they always need to be preplanned? What about repeating a resection after pathology shows more margins
  • Modifier 79: What defines an unrelated procedure? Is a different diagnosis essential?
  • Modifier 78: Does this apply to in-office procedures? How to report in-office treatment of post-operative complications.

Documentation for Unlisted Procedures

  • How to report unlisted procedures and get paid
  • Template letter for reporting unlisted codes
  • Case scenarios

Breast Procedures

  • 2018 CPT changes in breast coding: Intraoperative placement of clips during breast procedures, intraoperative radiation therapy (IORT)
  • Breast biopsy: percutaneous, incisional and excisional
  • Sentinel node mapping and excision
  • Mastectomy coding: Lumpectomy, simple and radical mastectomies
  • Case scenarios

Hernia Surgery

  • Hiatal/paraesophageal hernias: Type 1, 2, 3, 4
  • Open/laparoscopic hernia repair
  • Reporting mesh placement and hernias with other procedures: When is it appropriate?
  • Component separation release/abdominal reconstruction
  • Case scenarios

Endoscopy Coding

  • General concepts in endoscopy coding
  • Colonoscopy
  • Sigmoidoscopy vs. colonoscopy: How far is far enough?
  • Case scenarios

Colorectal Surgery

  • Approach matters: Laparoscopic vs. Open
  • Partial colectomy and proctectomy
  • Total and subtotal colectomy
  • Stoma creation, revision and closure
  • Case scenarios

Bariatric Surgery

  • Coverage policies: Clinical criteria and approved  procedures
  • Paraesophageal hernia repair: When is it separately reported?

Appendix Surgery

  • Laparoscopic vs. Open
  • Laparoscopic repair of a rupture appendix
  • Case scenarios

Gallbladder and Liver Surgery

  • Cholecystectomy
  • Liver resection vs. biopsy
  • Case scenarios

Incompetent Vein Treatment

  • Sclerotherapy, non-compounded foam
  • Ablation Coding: RFA and Laser, Mechanochemical, Chemical Adhesive
  • Ultrasound coding post ablation

Endocrine Surgery

  • Thyroid
  • Parathyroid