Category: CC-General Surgery

OOOPs. I Nicked a Vessel. Can I Bill for Repairing it?
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OOOPs. I Nicked a Vessel. Can I Bill for Repairing it?

April 29, 2021 Question: The surgeon accidentally nicked a vessel not involved in the bypass being performed, can he bill for repair of vessel since he had to repair it? Answer: Iatrogenic, intraoperative complications that are repaired at the same operative session are not separately reported. Since the vessel laceration was an iatrogenic injury, inadvertently...

Co-Surgeon or Assistant?
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Co-Surgeon or Assistant?

April 15, 2021 Question: A vascular surgeon is requested to come to the OR to repair a blood vessel that my surgeon inadvertently nicked during a colectomy. Is he a co-surgeon or assistant on the case? Answer: Neither. The vascular surgeon will report his work, repair of vessel, and you will report yours. *This response...

Modifier 58 vs. Modifier 78
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Modifier 58 vs. Modifier 78

March 18, 2021 Question: Do some insurance carriers want modifier 58 and others want 78?  What is the difference in these modifiers? Answer: Modifier 58 is used on a subsequent surgery when a planned (or staged) related procedure is performed within the global period of the first surgery. If possible, but not required, the surgeon...

Use of Modifier 52
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Use of Modifier 52

February 18, 2021 Question: My surgeon was called into a laparoscopic operation that was already underway, to perform extensive lysis of adhesions. Does he need to use a modifier 52 because the patient was already “opened”, or can we just bill for 44180 Laparoscopic lysis of adhesions? Answer: You would bill for 44180 without a...

Separate Procedure Billing
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Separate Procedure Billing

February 4, 2021 Question: The surgeon performed an open colectomy and found a tear in the mesentery close to the incision, 44850 Suture of mesentery is listed as a “separate procedure”, does that mean we can bill for it separately in addition to the colectomy? Answer: No, codes designated as a “separate procedure” are intended...

New 2021 E/M Coding Guidelines
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New 2021 E/M Coding Guidelines

January 21, 2021 Question: In the new guidelines, how does Time affect billing for a teaching physician’s E/M service when the resident spends a great deal of time with the patient? Answer: Good question! Only the time of teaching physician would “count” in the scenario you describe. The new guidelines say that the time of...

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