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A Abdomen, Peritoneum, and Omentum Sub-Section of Surgery

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A Abdomen, Peritoneum, and Omentum Sub-Section of Surgery Index A for photodynamic therapy, 286 Abdomen, peritoneum, and omentum for placement of adjustable suture during sub-section of surgery, 151–152 strabismus surgery, 203 Abortion, 179 plus symbol (+) to designate, 14, 74 Accessory sinuses, endoscopies of, 112 for previous eye surgery, 203 Accounts receivable (A/R) management, for qualifying circumstances for 384–386 anesthesia, 291 aged accounts receivable and claims for surgery, 73–74 follow-up for, 384–385 for veins harvested for bypass grafts, 128 appeals process in, 385–386 for vertebral levels in rhizotomy, 191 definition of, 384 Additional codes denial management as part of, 385 for additional tissue block from same tracking amounts using days in accounts specimen, 252 receivable for, 384–385 for application of stereotactic headframe, Accreditation Association for Ambulatory 185 Health Care (AAAHC), 3 for arthrodesis, 100 standards for basic elements of health for audiometric tests, 271 records set by, 8–9 for breast procedures, 88 Accreditation organizations and standards, 3 for cardiac catheterization, 273 Accredited Standards Committee (ASC) X12 for cardiovascular myocardial perfusion Electronic Data Interchange (ASC X12) and cardiac blood pool imaging transaction and code set standards, 379 studies, 231 Acellular dermal grafts, 85 for injections, 265, 266, 283–286 Acellular xenogeneic implant, 85 for intracardiac echocardiography during Acupuncture, 289 therapeutic/diagnostic intervention, 273 ADA Dental Claim Form, 303 for multiple vessels in procedure, 275 Add-on codes for operating microscope for surgical for anesthesia, 40 services, 203 for angioscopy during therapeutic for physician standby services, 342 intervention, 131 for reconstruction procedures on ear, 203 for computer-assisted, image-guided for skin grafts in addition to primary navigation, 113 procedures, 85 for coronary artery blocked vessels, 275 for spinal instrumentation, 101 for critical care services, 336 when to use, 29–30 for electrode arrays, 185 Additional procedures, separate codes for, 74 for iliac artery angioplasty, 135 Adenoidectomy, 146–147 for intravascular ultrasound, 276 Adjacent tissue transfer or rearrangement, 84 for mammography, 225–226 Administration of contrast materials, 234 523 Index Administrative law judge (ALJ) hearing for medical direction of, Medicare and reimbursement decision, 386 Medicaid coverage of, 44–45 Advance beneficiary notice (ABN), 374 qualifying circumstances for, 42, 291 modifiers for, 374, 376 regional, as separate from surgical Aged accounts receivable, 384–385 package, 171 AHA Coding Clinic for ICD-10-CM, 10 steps in coding, 42–43 ALJ hearing. See Administrative law judge team approach for providing, 44 (ALJ) hearing for reimbursement decision time charges for, 43–44 Allergen immunotherapy, 281 Anesthesia types included and not included Allergy and clinical immunology, 280–281 in surgical package, 71 Allergy testing, 280–281 Anesthesiologist assistant (AA), 38–39 Allograft (human skin), 85 time charges for, 43 corneal endothelial, 196 Aneurysm, 137 definition of, 85 abdominal aortic, 131 tissue cultured, 85 Angiography, 224 Ambulatory coding guidelines for ICD-10-CM, Angioplasty 27–30 balloon, 275 accessing and downloading current, 27 iliac artery, 135 Ambulatory surgery, diagnosis for, 30 transluminal, 120, 275 American Academy of Professional Coders Angioscopy, 131 (AAPC), 32 Antepartum and/or postpartum care only, American Dental Association, Current Dental 177–178 Terminology (CDT) of, 146, 303 Anterior segment of eye, 195, 196–198 American Health Information Management Anus, surgery on, 149 Association (AHIMA) Appendectomy, 148 certifications by, 32 Aqueous shunt to extraocular reservoir, 196 ICD-10 resources of, 10 Arterial catheterizations, 131–132 American Medical Association (AMA) Arteriogram, 137 CPT code book first developed by, 10 Arteriovenous fistulas, 134 E/M service documentation guidelines by Arthrodesis codes, 100 CMS (HCFA) and, 310 Arthroscopies, diagnostic and surgical, revisions of CPT code book by, 10 105–106 American Society of Anesthesiologists (ASA) Atherectomy, 275–276 ranking system of, 40 Attorney–client privilege, 424–425 time units and relative values system of, 43 Audiologic function tests, 203, 271 Amount and/or complexity of data to review Audiometry, 203 for medical decision making, 317 Audit Anastomosis to analyze coding information, 419 arteriovenous, 134 attorney–client privilege for completing, of multiple-vein segments, 131 424–425 preparation of artery for, 131 baseline, physician office, 433 in stomach, 147 conducting, 311, 425–427 Anatomic pathology determining size of sample for, 426 consultations for, 247, 251–252 factors that trigger, 424 physician services for, 249 following up, 426–427 Anesthesia, general, ophthalmological identifying need for, 424 examination performed under, 270 preparing for, 424–425 Anesthesia section, 18, 37–52 steps in performing, 425–426 codes used in reporting qualifying steps in performing internal, 425–426 circumstances in, 42 time required to complete, 426 format and arrangement of codes in, 38 Audit tool to assess quality of coding, 419 modifiers for, 39–41 based on 1995 guidelines, 419, 421–422 Anesthesia services based on 1997 guidelines, 419, 423 anesthesia package for, 39–40 Auditory system subsection of surgery, fees for, calculating, 43–44 199–203 524 Index Autograft (autologous) skin graft Bone marrow biopsy codes, 97, 248 definition of, 84 Bone scans, 231 tissue cultured skin in, 85 Bones of foot, diagram of, 103 Brachytherapy B clinical, 229–231 Bad debt write-off, 384 definition of, 228 Balanced Budget Act of 1997 (BBA), 376 for radiation oncology, 228–230 Bariatric surgery, laparoscopic, 147–148 Breast procedures, 88–90 Bell curve graph, 400 Bronchial valves, 113–114 Benign lesions, 80–81 Bronchoscopies, 113–114, 286 Biliary tract, 141, 149–150 Bullet (•) in CPT code book to designate Biller, teamwork of coder and, 409–410 new code, 13, 302 Billing abuse Bundling of services, improper, 405 as audit trigger, 424 Bunion repairs, 103–104 avoiding allegations of, 311. See also errors in coding, 428 Fraud and abuse Burch procedure, 173 inflated medical billing as, 431 Burns Billing, component, 282, 376 debridement of, 80 Billing database, physician, 394 local treatment of, 87–88 Biofeedback, 268 Bypass graft, veins and arteries harvested Biopsies for, 124–128 bladder/urethra, 160 bone, 97 C bone marrow, 97, 248 C codes as inappropriate for billing breast, 88–89, 136 professional services, 303 digestive system, 143 Capitation payment arrangement, 365 excisional versus incisional, 88 Cardiac anomalies, complex, 127–128 female genital system, 171 Cardiac catheterizations, 120, 136, 272–275 hysteroscopic, 175 Cardiac procedures, HCPCS codes for, 294 lung and pleura, 114 Cardiac scans, 231 lymph node, 136 Cardiac valves, 124 male genital system, 170 Cardiography and cardiovascular monitoring mediastinum, 137 services, 272 miscoding, 428 Cardiopulmonary resuscitation, 278 prostate, 170, 251 Cardiovascular device monitoring, 272 sentinel node, 136 Cardiovascular, hemic and lymphatic systems ureter, 161 of surgery, 120–138 Birthday rule for primary and secondary Cardiovascular monitoring services, 272 payers, 381 Cardiovascular subsection of medicine, 271–275 Birthing room attendance, 348 Cardiovascular system subsection of surgery, Bladder, 161–163 120–138 Blood draws (venipuncture), 244–245 miscellaneous guidelines for, 136–137 Blood flow to and from heart, diagram of, Care plan oversight services, 343 120–124 Case management services, 343 Blood gases and information data stored in Casts and strapping, 96, 104 computers, 339 Cataract extraction Blood or blood component transfusion, 376 common errors in coding, 429 Blood transfusions and provision of blood ECCE and ICCE, 197 products, 255 implant procedures in, 197 Body size, measuring, 85 procedures included in, 197 Boldface for main terms in CPT code book terminology for, 197 index, 17 Catheters Bone density study, 235 arterial, 39 Bone flaps, 182 bronchoscopic placement of, 113 Bone grafts, 98, 100, 189 cardiac, 120, 136, 272–275 525 Index codes for placement of, 131, 132, 272 Chemistry, 247–248 epidural, 47–48 Chemotherapy, 229 hyperalimentation or hemodialysis, 120 administration of, 285–286 inserted by physician rather than nurse, 132 Chest x-rays, 224, 339 intra-arterial, 39 Chief complaint used for coding, 27 nonselective and selective, in definition of, 314 interventional radiology, 227 in history component of E/M service, 314 in pelvic organs and/or genitalia, 170 Childbirth and parenting classes, 179 removal of, 132 Chiropractic manipulative treatment (CMT), suprapubic, 172 289–290 ureteral, 161–162 Chronic diseases, coding, 29 venous, 132–133 Circumcision, 169–170 Cell washings and brushings, 113 Claim adjustment reason codes, Washington Centers for Medicare and Medicaid Services Publishing Company tables of, 409 (CMS) Claim denial ambulatory coding guidelines by NCHS C codes on CMS-1500 form resulting in, 303 and, 27 caused by failure to perform steps in claim form for billing. See CMS-1500 claims process, 383 claim form denial management for, 385 CPT code book included in Healthcare diagnosis codes as cause of, 404 Common Procedure Coding System by, NCCI edits signaling, 377–378 10–11 noncoding reasons for, 409 National Codes updated by, 302 nonspecific diagnosis code causing, 398 National Correct Coding Initiative preventing, 385 developed by, 377 speeding Medicare, 374 payment for consultation codes eliminated
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