To correctly assign codes for any surgical procedure, coders need to have an operative (OP) report. But simply having the OP report isn't enough. Coders also must be able to read the report and pick out the important information.
Facilities can't bill for skin substitutes unless they also bill for a skin substitute application procedure on the same date, according to the April update to the I/OCE. If facilities don't comply with this practice, they won't receive payment for the skin substitute. The April update includes a list of eight procedure codes (CPT codes 15271-15278) and 27 specific skin graft materials.
Spinal conditions can be congenital, pathologic, or traumatic, and they can affect the vertebrae, spinal cord, muscles, nerves, discs, or a combination of the parts of the spine.
Editor’s note: To help coders prepare for the upcoming transition to ICD-10-CM, we will provide occasional articles about specific anatomical locations and body parts as part of a larger series for ICD-10-CM preparation. This month’s column addresses digestive system.
Modifier -PD (diagnostic or related nondiagnostic item or service provided in a wholly owned or wholly operated entity to a patient who is admitted as an inpatient within three days or one day) is now included in the I/OCE, according to January updates detailed in Transmittal 2370 .
Self-administered drugs present a significant issue for coders, especially when considering how they may or may not be covered by Medicare Part B. In many instances, payers may consider a drug to be self-administered in some circumstances but not in others. As a result, coders must pay special attention to how these drugs are used within their setting.
Our coding experts answer your questions about determining ED visit level, coding open reduction and internal fixation of a radius fracture, and coding image-guided minimally invasive lumbar decompression.
Because CMS has not created any national ED E/M guidelines, providers must create their own criteria for each visit level. CMS has developed a list of 11 criteria that it uses when auditing facility E/M criteria.