Agenda
*agenda subject to change
7:00AM — 8:00AM
Check-in and Breakfast (provided)
8:00AM – 9:45AM
Definition Kick-off
- The basics: defining coding vs reimbursement
- Types of codes: primary, add-on, Category III
- What is a separate procedure per CPT?
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 surgery documentation.
- Reimbursement: Difference between co- and assistant surgeon.
Same-Day Procedure Modifiers
- Modifier 22: What justifies modifier 22 and how to increase your chances of payment?
- Modifier 50: Which procedures accept a bilateral modifier?
- Modifier 51 vs. 59: How do you know which one to use? How does reimbursement differ for each?
- Modifier 52 vs. 53: What is the difference and how are they used in general surgery?
Modifiers for Additional Procedures Performed During the Global Surgical Period
- Modifier 58: Documenting staged 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 do I report in-office treatment of postoperative complications?
Revenue Optimization: Charge Entry Tips of the Trade
Documentation for Unlisted Procedures
- How to report and get paid.
- Template letter for reporting unlisted codes.
- Case scenarios.
9:45AM – 10:00AM
Break
10:00AM — 12:00PM
Surgical Coding and Documentation
Surgical Approaches and Code Selection: Percutaneous vs. Open vs. Laparoscopic – Does it Matter?
Radiology Coding and Documentation for Surgeons
- Fluoroscopy and ultrasound: Is a separate report required?
- Documenting imaging with central lines: Fluoroscopy or ultrasound or both?
Hernia Surgery
- Hiatal/paraesophageal hernias: Type 1, 2, 3, 4.
- Open/laparoscopic hernia repair.
- Reporting other procedures with hernias codes – CPT rules vs. payor realities.
- Reporting mesh placement.
- Reporting mesh removal; infected and non-infected mesh.
- Component separation release/abdominal reconstruction.
- Case scenarios.
Gallbladder and Liver Surgery
- When can a cholangiogram be separately reported?
- Liver biopsy. Percutaneous vs. open
- Liver resections – How many hepatectomies (47120) are too many?
- Case scenarios.
12:00PM — 1:00PM
Lunch
1:00PM — 2:30PM
Procedure Coding (continued)
Endoscopy Overview
- General concepts in endoscopy coding: completion endoscopy – billable or not?
- Moderate sedation: are you documenting enough?
- Upper GI endoscopy overview.
- Colonoscopy: Sigmoidoscopy vs. colonoscopy: How far is far enough?
- Case scenarios.
Colorectal Surgery
- Approach matters: Laparoscopic vs. Open vs. Robotic
- Partial colectomy and proctectomy.
- Coding a low pelvic anastomosis and diverting ileostomy.
- Defining LAR.
- What’s the difference between colostomy and coloproctostomy?
- Total and subtotal colectomy: Is there a difference?
- Stoma creation, revision, and closure.
- Case scenarios.
Appendix Surgery
- Lap vs. Open
- Laparoscopic repair of a ruptured appendix.
- Case scenarios.
Intra-abdominal Tumor Resection
- What can be separately reported?
- Coding HIPEC and getting paid.
2:30PM — 2:45PM
Break
2:45PM — 4:00PM
Procedure Coding (continued)
Endocrine Surgery
- Thyroid
- Parathyroid
- Adrenal
Breast Procedures
- Breast biopsy: Percutaneous, incisional and excisional
- Sentinel node mapping and excision.
- Mastectomy coding: Lumpectomy, simple and radical mastectomies.
- IORT Coding.
- Case scenarios.
Bariatric Surgery
- Coverage essentials: Does pre-authorization always guarantee payment?
- Paraesophageal hernia repair: When is it separately reported?
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