Proper payment relies on a solid understanding of the guidelines. Many physicians and coders are confused by the differences among CPT® definitions, American Academy of Orthopedic Surgeons (AAOS) Global Service guidelines, and Medicare’s National Correct Coding Initiative (NCCI) guidelines and procedure-to-procedure edits affecting arthroscopic knee CPT® codes. There also is confusion about when mo...
In Coding
May 1st, 2014
Make it known: Guidelines drive coding, compliance, reimbursement, and quality of healthcare. By Ken Camilleis, CPC, CPC-I, CMRS, CCS-P You rely heavily on a variety of guidelines to assist in your work as a coder. Guidelines come from ICD-9-CM and ICD-10-CM, CPT®, payers, government agencies, and a host of other sources. There is no “one size ...
Jul 1st, 2010
By Sarah Sebikari, MHA, CPC CPT® codes designated as “separate procedures” are generally incidental and bundled into a comprehensive/major procedure when performed during the same session, through the same incision, and/or on same anatomic site. The Centers for Medicare & Medicaid Services (CMS) does not allow separate reporting of a procedure designated as a separate ...