I used to work for General Surgeons, so I am familiar with the soft tissue excision codes from the musculoskeletal part of the CPT book, but I am now coding for Dermatology, and am trying to determine at what depth, is it appropriate to stay in the benign lesion excision area versus when to hop on over to the 2xxxx M/S soft tissue codes. I know the M/S codes say subcutaneous or subfascial, and in the Dermatology practice I’m coding for we are excising these from the subcutaneous tissue, but from the documentation it sounds like it is superficial sub Q, and there is rarely a layered closure.. Will any payers allow the M/S codes to be used in a POS 11? When I coded for General Surgery, these patients were taken to an ASC to have these removed. At the Dermatology practice, they are removing them in our surgical suite with local anesthetic, but it is still POS 11. Our newest PA is also inquiring whether she can bill a first assist for lipoma surgery It is allowed on the M/S codes usually, but only on the larger 114xx codes. Thoughts anyone?
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Tag Archives: General
General Anesthesia during Excision
We have a provider who excised a malignant lesion on the forearm under general anesthesia.
The problem is that we cannot find a code to bill the MAC anesthesia under.
Does anyone have any advice on this?
General Surgery and bundling
I am hoping to have some help with the below report. At times our management questions why we didn’t code something therefore the codes use on this were 43640, 43610-59. The reasoning behind coding the 43610 was that it was sent out for pathology. Thing is, it was excised and not just biopsied. Any thoughts?
Exploration revealed a large antral ulcer anteriorly. This antral ulcer is adjacent to the pylorus. I cut out the ulcer and submitted it for histopathology to check for cancer. Next, the pylorus was cut open and pyloroplasty was carried out using 2 layer closure. Then, the vagal nerves were identified. The left anterior vagal nerve was first identified and a right angle clamp was used to hold it up and 2 clips were placed proximal and distal prior to its division. The peritoneum between the esophagus and liver was opened up and the esophagus was dissected circumferential. The posterior right vagal nerve was identified and a right angle clamp was used to hold it up followed by the nerve foot and the clip was placed proximal and distal x2 and vagal nerve was divided.
Looking for an (on-site) General Practice coding specialist position? Albany, NY
Hi all!
Just curious if anyone (evenly the newly tested and passed) is looking for a FT position with a great company? I am currently heading to another facility to change my coding direction but would love to assist in finding someone to fill my spot! 
Mohs surgeon billing under the general dermatologist’s NPI
I have always been under the impression that one doctor cannot bill under another doctor’s NPI except under a true Locum Tenens situation. But a friend who works in another derm practice says that her doctor brings in a Mohs surgeon once a week and bills insurance under his own name for the Mohs surgeon’s work. When my friend told him he is not allowed to do this, he replied that he has checked into this and found that it is permitted.
Is there something I don’t know here, or is he committing fraud?
Fraud Reality Show Features Office of Inspector General
Have you always wanted to see what an Office of Inspector General (OIG) investigational take down of a healthcare fraud scheme is like? Now is your chance. The U.S. Department of Health and Human Services’ (HHS) has a “This is Real” series of podcasts, which takes you undercover with OIG special agents as they work […]
AAPC Knowledge Center
Fraud Reality Show Features the Office of Inspector General
Have you always wanted to see what an Office of Inspector General (OIG) investigational take down of a healthcare fraud scheme is like? Now is your chance. The U.S. Department of Health and Human Services’ (HHS) has a “This is Real” series of podcasts, which takes you undercover with OIG special agents as they work […]
AAPC Knowledge Center
Neurology General Coding/Billing & Billing for E/M, EEG, LP done same day in hospital
Am working in office for neurologist who does consultations in hospital. Was told only ICD-10 codes related to neurology should be listed on claim when billing CPT E/M Consult/Followup and Procedures codes for services provided to patients while in hospital by our doctor.
Question 1: Was informed we should first list the "admitting diagnosis" (not the "principal diagnosis") found on the hospital’s billing summary along with only the neurology codes listed. Does this sound right?
Question 2: Should we be listing ICD-10 codes for co-morbidities and/or complications that affect the neurologist’s treatment/medical management of patient? For example, patient has stroke and also has AFib. Shouldn’t we list the ICD-10 codes for both stroke and AFib?
Question 3: When a consult or followup are done on the same date of service as an EEG and/or lumbar puncture (spinal tap) as an inpatient, what modifiers should be attached to E/M and/or procedure codes for the neurology specialist performing them? Debating use of modifier 59 vs. XE when FUp, EEG, and lumbar puncture are done at different times on same date of service. Also, do we have to use HCPCS code AF on E/M or procedure codes to indicate specialist physician service as well as -59 or -XE modifier?
Any helpful advice/guidelines would be appreciated. Thank you.
General Surgery Certification
I am considering taking the General Surgery exam soon. Any tips?
General Medical Care for Minor Emergencies
Minor injuries are usually the most troublesome type of injury because even though they are minor, they still need some type of medical treatment. It almost seems like a waste to go to the hospital to fix a minor injury after you see the bill, and you will find yourself waiting even longer in line because the hospital will see that your injury is not first priority. By going to a clinic that offers general care for minor injuries, you can get professional help quickly, safely, and at a great price.
Most injuries in general are minor, or people can usually tell the difference between an injury that is minor, and an injury that is very serious. Having a care center that specializes in taking care of minor injuries such as small cuts, scrapes, sprains, and other relatively temporary injuries is the best way to go.
If you have a small cut, then getting it cleaned and properly treated is a very quick and easy process. If the cut appears to be a large enough wound for stitches, you should seek medical help for this as soon as possible because stitches can only be applied to wounds up to 8-12 hours after the cut has been made. The best way to treat any abrasion of the skin is to just keep it clean by washing it regularly and keeping it covered up away from germs to avoid infection.
Many adults and kids alike often receive some type of sprain from doing average, daily exercise. It is very easy to trip over something and sprain your ankle. Even though sprains aren’t considered major medical emergency, they still can cause problems down the road if mistreated. Your local general medical care provider can be sure to tell you what type of sprain you have, and will tell you all the steps needed for a full recovery.
The reason a medical center that specializes in helping people with minor emergencies and common sicknesses can save you time and money has a lot to do with multiple things. They are better staffed than a hospital because the clinic itself is not too big. They can charge less because they do not have the overhead a hospital or large doctors office might have. And they can save you a lot of time because they are typically not overcrowded and do not prioritize your injuries. This makes it the best choice for any minor injury emergency for any family.
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