General Surgery Coding Alert
Medicare Proposes, Rescinds 'Medically Unbelievable' Edits
The Centers for Medicare and Medicaid Services announced in Transmittal 105 (Feb. 18, 2005) that it had hired AdminaStar Federal to develop MUEs to target multiple claims for particular services made for one patient on the same day.
Carriers have had frequency edits in place for years, says consultant Quinten Buechner, MS, MDiv, CPC, president of ProActive Consultants in Cumberland, Wis. The MUEs, then, although adding complexity to the NCCI, may have helped to standardize practices among all payers.
At this point, however, general surgery practices needn't worry about a new category of NCCI edits. Only a few weeks after its initial announcement, CMS rescinded without explanation its plans to establish the MUEs.
A source within CMS confirmed, however, that the agency expects to reissue the MUEs, with modifications, at a later (undisclosed) date. Keep reading General Surgery Coding Alert for more information as soon as it becomes available.
General Surgery Coding Alert
- Diagnostic and Screening Colonoscopies Call for Different Coding Strategies
V code diagnoses provide justification for screening exams
When choosing a code for a screening colonoscopy [...] - You Be the Coder:
How Many Hemorrhoids?
Question: Can I report one unit of 46221 for each hemorrhoid the surgeon removes using [...] - Yes, You Can Bill Multiple Thoracoscopies
Medicare requires you to bundle 'converted' scopes to open procedures
Most general surgery coders are familiar [...] - Limit Size-Based Debridement To Nonphysician Staff
Incorrect 97597-97598 claims could mean up to $250 less
For your surgeon's debridement services, you should [...] - READER QUESTIONS:
Decompression Bundled to Colonoscopy Code
Question: A patient presented with a pseudo-obstruction in the colon. The surgeon placed a decompression [...] - READER QUESTIONS:
Don't Bundle Wedge Biopsy of Liver
Question: The surgeon performed an exploratory laparotomy and wedge biopsy of the liver. She excised [...] - READER QUESTIONS:
Payers Treat Group Practices as 1 Provider
Question: If Surgeon 2 in our group practice provides post-op care for a patient whom [...] - READER QUESTIONS:
Exploration Affects Secondary Closure
Question: On several occasions, our surgeons have performed bowel surgery and have had to leave [...] - READER QUESTIONS:
Excision Codes Still Count for Stoma Site
Question: How should I report excision of a skin lesion at the stoma site?
Oklahoma Subscriber
[...] - READER QUESTIONS:
Previous Hospital Care May Affect E/M Reporting
Question: A provider insurance representative recommended at an in-house seminar that if our surgeon sees [...] - READER QUESTIONS:
Use Soft Tissue Code for Post-Mastectomy Excision
Question: How can we code for a patient who has already had a mastectomy due [...] - READER QUESTIONS:
Depth Determines Lymphadenectomy Code
Question: Which code properly describes axillary lymphadenectomy?
Virginia Subscriber
Answer: The code you choose depends on [...] - News In Brief:
AMA May Develop Its Own Correct Coding Initiative
Surgery coders may soon face an additional layer of guidelines, because the AMA, which oversees [...] - Medicare Proposes, Rescinds 'Medically Unbelievable' Edits
If you've heard rumors of a new category of coding edits, you can take a [...]
