CPT Seminar Welcome to Seminar

Rule 1: When you need to ask a question to the instructor, you will raise your hand by placing two ?? After your question. This signals that you have a question for the instructor.

Example: Student 1: Type Type Type Student 2 Type Type Type Student 1 Type Type??

Rule 2: Stay on Topic. If you wish to talk to another student about something, please email him or her after seminar

If we seem to be getting off track, or too much is going on, I will say: HOLD UP. That is your cue to stop typing so we can refocus.

Seminar Ground Rules:

Seminar Ground Rules ContinuedRule 3: Remember Netiquette. You should respect

everyone. Do not use all caps as that means you are shouting.

Rule 4: Be prepared: In the future, I will sometimes provide reading material such as case studies for you to read or complete before seminar. This information will be placed under the seminar section of each unit.

Rule 5: Be actively involved in the seminar. In order to receive credit for seminar, you must actively participate and you must arrive on time and stay the entire hour. If you leave early, you will not receive credit.

Seminar Option 2:If you cannot attend seminar, you may choose

the Seminar Option 2This option is harder and will be graded

harderThis option requires you to write an essayEssay must use proper English grammarResponses provide detailed examplesMust meet length requirementsNo credit will be given for late option two

assignments.

Surgery Section is the Third Section of the CPT ManualCodes begin with 1, 2, 3, 4, 5, or 6These are invasive proceduresNon-invasive procedures would not be in this

section. They would be found under the E/M Section

Majority of Surgery Section is arranged from outside to inside of the body

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Surgical PackageSurgical package includes specific details

that cannot be coded as separate proceduresIf you code them separately, you would be

overcoding and it could be deemed as fraudCPT and Medicare have different rules for

what is contained in the Surgical Package

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Separate Procedure ContinuedAppears in

parentheses after code description

Ask yourself if the separate procedure code is an integral part of another procedure

A modifier such as -59 distinct services should be added to explain

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Example of Separate ProcedureLook up code 44820Excision of lesion of mesentery (separate

procedure)Included in code 44800 Excision of Meckel’s

diverticulectomy or omphalomesenteric duct

Would not use code 44820 unless it was done by itself.

Integumentary System

Four Rules For Coding RepairsRule 1: Repairs must be measured and

reported in centimetersRule 2: Multiple wounds within the same

location given in the description of the code should be added together and reported

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You Code ItA child is seen in the physician’s office for a

superficial laceration of the right knee. The physician repairs the 3.0 cm laceration with simple suturing

Answer: 12002 Simple repair of superficial wounds of scalp, neck, axillae, external genitalia, trunk and/or extremities (including hands and feet) 2.6 to 7.5 cm.

Rule Three: Debridement and Contamination are a part of the global service. Can’t code separately except:

Prolonged cleansingAbove average tissue

amount is removedCarried out separately

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Rule 4: Involvement of Nerves, Blood Vessels and Tendons

When any nerve, blood vessel, or tendon is repaired, the code from the Nervous, Cardiovascular, or Musoskeletal System should be used instead of the Integumentary.

One exception: When the physician performs a complex repair in addition to repairing the nerve ect., You can code repair

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Coding ExampleRepair of cardiac wound would be:33300 Repair of cardiac wound; without

bypassThis code is found under Cardiovascular

System and not Integumentary System

Musculoskeletal System

Casts and StrappingDo not code for the

initial cast or strappingCodes between 2000-

28889 include the application and removal of the first cast or traction device

Using an additional code from the 2900 series would be incorrect

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Coding ExampleClosed reduction of proximal humerus fracture,

right

23605 Closed treatment of proximal humeral (surgical or anatomical neck) fracture; with manipulation with or without skeletal traction

EndoscopyEndoscopy means “looking within”.Codes are categorized by body part and then by type

of endoscopy: surgical or diagnosticSurgical always includes diagnostic and should

not be coded separately

Respiratory System

Bilateral versus Unilateral ProceduresProcedures are unilateral. When the services

are not meant to be unilateral, the code will tell you.

If you are using a code that does not say anything about being bilateral, and you provide a service that is done on both sides, you will use a modifier -50 Bilateral Services on the second side

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Coding ExampleBilateral nasal endoscopy with total

ethmoidectomy

31255-50

ModifiersAdd details to codesA list can be found

in Appendix ASome apply only to

hospitalsOthers apply to

physician servicesYou must learn

these-memorize them!

This Week: Sept 13- Sept 19Proctor Form is DueDrop in Proctor Drop Box on Course Home.

Instructions and Form can be found under doc sharing

Karen Kuharic is the proctor at SCCC/ATS. She is in Room 102 and her number is 620 417 1105

Assignment DiscussionNo Seminar on Sept 20th

Questions???

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