Wound Care: Refer to This Handy Chart to Make Graft Coding a Cinch

Careful: Skip over codes for legs and zero in on foot codes.

With the many graft options — including those taken from cadavers, pigs, and newborns — correctly coding a skin graft procedure can leave you guessing. Use this chart to narrow down the grafting field by matching definitions, product names, and treatment applications to CPT codes. Then, you’ll be sure to sail through coding your next graft claim.

Don’t miss: Nothing will get your claim denied faster than using a CPT code not linked to the diagnosis code. Thus, take care to avoid CPT codes for other body areas, such as the legs, which are generally listed above the code for the feet for each type of graft. Below, you will find only CPT codes that you can use to report grafts performed on feet.

Note: Be sure to periodically review the payer’s local coverage determination to ensure your office is in compliance for your state or region.

Remember: Site preparation, lesion excision, and supply (HCPCS) codes may also apply for these services (in addition to the above listed CPT codes). Look in future issues for more on coding skin graft services by subscribing to Podiatry Coding & Billing Alert. Editor: Stacie Borrello.

Sign up for the upcoming live Webinar, Why That Wound Won’t Heal: Practical Tips to Get Wounds Moving, or order the CD/transcripts.

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Fibroid Coding Got You Frustrated? 5 Myth Busters Fix Your Claims

Find out what your fibroid diagnosis options are for both ICD-9 and ICD-10.

If you’re reporting uterine fibroid removal, you need to know two things:

  • Where the fibroid was located, so you can choose the diagnosis code.
  • What method the obgyn used to take care of the growth.

Simplify this complicated coding scenario by busting the following four myths.You’ll know where to look in both your ICD and CPT manuals before the fibroid report lands on your desk.

Don’t Confuse Fibroids With Polyps

Myth: Fibroids and polyps are essentially the same thing.

Reality: True, fibroids and polyps are both growths, but one occurs in the endometrial lining while the other occurs in the muscle.

Polyps are small growths on the surface of the uterine wall that are easy for the ob-gyn to remove. In other words, “they are an overgrowth of the endometrial lining,” says David Glassman, DO, FACOG, medical director of Biltmore Women’s Health and Aesthetics and assistant program director at the department of obstetrics and gynecology residency at Banner Good Samaritan in Phoenix. “They’re intracavitary lesions.”

Fibroids (or myomas) are larger and are usually imbedded in the smooth muscle of the uterine wall. “They are almost always benign, but in rare circumstances, they can become a sarcoma (muscle cancer),” Glassman says. These growths require more work to remove, hence the procedures associated with fibroids tend to have more relative value units (RVUs). They occur in three main locations:

  • Submucous fibroids (218.0) grow from the uterine wall toward the uterine cavity. They are also called intracavitary fibroids.
  • Intramural fibroids (218.1) also called interstitial fibroids grow within the uterine wall (myometrium).
  • Subserous fibroids (218.2) or subperitoneal fibroids grow outward from the uterine wall toward the abdominal cavity.

If the physician does not specify the location…

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ICD-9 Coding: Stop Asking ‘Which Diagnosis Code Will Get My Claim Paid?’

Assigning an ICD-9 code merely to get your claim paid could land you in legal hot water.
Medical coders face a lot of questions each day in the course of their work, but one question you should not be asking is “which diagnosis code should I put on this claim if I want to collect?”
When […]

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E/M Coding: Don’t Sell Yourself Short on Problem Sports Exams

Tip: Time-based E/M might be in line when managing diabetes, asthma, ADHD.
Overlooking time as the key factor on a camp or sports exam in which the patient has a problem could cut $30 per claim.
Opportunity: An office visit (99201-99215, Office or Other Outpatient Services) using time as the key factor might be appropriate, but keep […]

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Surgical Coding: Capture Extra Work for Choledochal Cyst

Discover these subsequent reconstruction codes.
Question: The surgeon treated a patient with a large choledochal cyst. The procedure involved an open cholecystectomy with en bloc excision of extrahepatic bile ducts (roux-en-Y reconstruction) with hepaticojejunostomy. What are the correct CPT and ICD-9 codes?
Answer: The correct ICD-9 code will depend on whether the patient has an acquired […]

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