SATURDAY

2023 General Surgery Coding: Revenue and RVU Optimization

Agenda

*agenda subject to change

8:00AM – 8:30AM

 New 2023 CPT Codes in General Surgery New!

  • All New Hernia Codes!
  • New mesh placement and removal codes for hernias, other abdominal reconstruction, and a delayed closure code!
  • New Bariatric Codes!

8:30AM – 9:15AM

Global Surgical Package and Modifiers in General Surgery

  • Global Surgical Package
    • What’s included in the global package, and what can be separately reported?
    • Using RVUs as a compensation metric: What you need to know.
  • Surgeon Role Modifiers
    • Co-surgery vs. assistant: Are you reporting these correctly?
  • Same-Day Procedure Modifiers
    • Modifier 22: What justifies modifier 22? and how to increase your chances of payment
    • Modifier 50: Which procedures accept a bilateral modifier?
    • Modifiers 51 vs. 59, 52 and 53.
  • Modifiers for Additional Procedures Performed During the Global Surgical Period
    • Modifier 58: Documenting staged procedures: Do they always need to be preplanned? What about repeating a resection after pathology shows more margins?
    • Modifier 79: What defines an unrelated procedure? Is a different diagnosis essential?
    • Modifier 78: Does this apply to in-office procedures? How do I report in-office treatment of postoperative complications?

9:15AM – 9:30AM

Surgical Approaches and Operative Note Documentation

  • What’s included and what is not included in General Surgery
  • Surgical Approaches and Code Selection – Does it Matter?
  • Coding for Robotic Assistance
  • Operative Report Dictation Tips

9:30AM — 9:45PM

Break

9:45AM — 12:00PM

Surgical Coding 

  • Hernia Surgery: NEW in 2023!
    • Open/laparoscopic hernia repair
    • Reporting another procedure with hernias codes
    • Reporting mesh placement: NEW in 2023!
    • Reporting mesh removal: NEW in 2023!
    • Hiatal/paraesophageal hernias: Type 1, 2, 3, 4
  • Abdominal Reconstruction/Component Separation
    • Myocutaneous flaps vs. Rives Stoppa
  • Bariatric Surgery
    • Open vs Laparoscopic vs Endoscopic
    • Coverage and Bundling
    • Bariatric Surgery and Paraesophageal Hernia Repair: When Can Both Be Billed?
  • Endoscopy Overview
    • Moderate sedation: are you documenting enough?
    • General concepts in endoscopy coding; completion endoscopy – billable or not?
    • Colonoscopy: sigmoidoscopy vs. colonoscopy: How far is far enough?
  • Colorectal Surgery
    • What’s the difference between colostomy and coloproctostomy? A sigmoid colectomy and a low pelvic anastomosis?
    • Total and subtotal colectomy; Is there a difference?
    • Stoma creation, revision, and closure
    • Small bowel resection

12:00PM — 1:00PM

Lunch

1:00PM — 2:30PM

Surgical Coding

  • Gallbladder Surgery
    • Cholecystectomy. Open vs laparoscopic?
    • When can a cholangiogram be separately reported?
  • Liver Surgery
    • Liver biopsy: percutaneous vs open
    • Liver resection coding
  • Endocrine Surgery
    • Thyroidectomy
    • Parathyroidectomy

2:30PM — 2:45PM

Break

2:45PM —4:00PM

Surgical Coding

  • Appendix Surgery
  • Breast Procedures
    • Breast biopsy: percutaneous, incisional, and excisional
    • Mastectomy coding: lumpectomy, simple and radical mastectomies
    • Reporting closures and local advancement flaps
    • Can placement of a marker in a lumpectomy cavity be reported?
    • Sentinel node mapping and excision
    • Lymph node dissection: How does this change coding?
  • Intra-Abdominal Lesion Resection
    • What can be separately reported?
    • Coding HIPEC and getting paid

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