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
Strategic Appeals: What to Do If You Hit a Brick Wall NEW!
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
Radiology Coding and Documentation for Surgeons
- Fluoroscopy and ultrasound: Is a separate report required? What about intra-operative imaging?
- Documenting imaging with central lines: fluoroscopy, ultrasound, or both?
Surgical Approaches and Code Selection; Percutaneous vs. Open vs. Laparoscopic – Does it Matter?
Coding for Robotic Assistance NEW!
- Using the HCPCS code
- Setting a fee and getting paid
Operative Note Documentation Best Practice Op Note Format NEW!
- Documentation to optimize coding accuracy and revenue
Hernia Surgery
- Hiatal/paraesophageal hernias: Type 1, 2, 3, 4.
- Open/laparoscopic hernia repair
- Reporting mother 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
Abdominal Reconstruction/Component Separation
- Documentation imperatives
- Myocutanoeus flaps vs. Rives Stoppa
All About Implants
- Biological vs. non-biological: knowing which to report
12:00PM — 1:00PM
Lunch (provided)
1:00PM — 2:00PM
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
- What’s the difference between colostomy and coloproctostomy? A sigmoid colectomy and a low pelvic anastomosis?
- 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
Gallbladder and Liver Surgery
- Cholecystectomy. When can a cholangiogram be separately reported?
- Liver biopsy: percutaneous vs open
- Liver resections – How many hepatectomies (47120) are too many?
Breast Procedures NEW Guidelines!
- Breast biopsy: percutaneous, incisional, and excisional
- Sentinel node mapping and excision
- Lymph node dissection: How does this change coding?
- Mastectomy coding: lumpectomy, simple and radical mastectomies
- Reporting closures and local advancement flaps
- Can placement of a marker in a lumpectomy cavity be reported?
- Case scenarios
2:00PM — 2:15PM
Break
2:15PM — 4:00PM
Procedure Coding (continued)
Pancreatic Resection NEW!
- Whipple procedures
- Other pancreatic resections
- Intra-abdominal vein reconstruction in abdominal procedures
Intra-abdominal Tumor Resection
- What can be separately reported?
- Coding HIPEC and getting paid
Endocrine Surgery
- Thyroid
- Parathyroid
- Adrenal
Presented by
