Cristina Bentin, CCS-P, CPC-H, CMA
Reimbursements for orthopedic surgeries under the Medicare ASC payment system are on the rise. But if you don't accurately report and code these cases, you won't receive the maximum reimbursement. This is particularly true, I've found, of common shoulder cases. Let's review a few of those procedures that, if coded improperly, could mean you're leaving money on the table.
Keywords:
Rotator cuff repair and reconstruction; Distal claviculectomy; Arthroscopic labrum repairs; Shoulder debridement; AAOS. The; AC; AMA; ASC; Academy; American Academy; Arthroscopic; CPT; Category III; Code Procedure MCR; Codes CPT Code Procedure MCR; Cuff Codes CPT Code Procedure MCR; Debridement Codes CPT Code Procedure MCR; II; III; IV; Lesion Arthroscopic; Medicare; Medicare ASC; Mini; Note; Orthopaedic Surgeons; Recall; Reimbursements; Remember; Report; SLAP; SLAP Lesion Arthroscopic; SLAP Type II; Simply; Surgeons; Type II; Type IV; Verify; abrasion; accurately; acute; addition; anatomical;...
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Rotator cuff repair and reconstruction; Distal claviculectomy; Arthroscopic labrum repairs; Shoulder debridement; AAOS. The; AC; AMA; ASC; Academy; American Academy; Arthroscopic; CPT; Category III; Code Procedure MCR; Codes CPT Code Procedure MCR; Cuff Codes CPT Code Procedure MCR; Debridement Codes CPT Code Procedure MCR; II; III; IV; Lesion Arthroscopic; Medicare; Medicare ASC; Mini; Note; Orthopaedic Surgeons; Recall; Reimbursements; Remember; Report; SLAP; SLAP Lesion Arthroscopic; SLAP Type II; Simply; Surgeons; Type II; Type IV; Verify; abrasion; accurately; acute; addition; anatomical; anatomy; anchors; anterior; apparent; application; arthroscopic; assumes; attaching; automatic; automatically; back; base; biceps; biological; bundle; capsular; capsule; capsulorrhaphy; carrier; carve; caution; chondroplasty; chronic; clarification; clavicle; clinical; code; coded; coder; codes; comfortable; commercial; common; complete; condition; conditions; confuse; considered; covers; cuff; debride; debridement; debridements; defect; define; degenerative; describe; description; detailed; determination; determine; diagnosis; difference; directing; distal; distinct; distinctly; document; documentation; edits; entry; excision; extensive; extreme; facility; fascial; feel; final; fiscal; forward; glenoid; grafting; guidelines; hard; head; humeral; identifiable; implants; imply; include; includes; inclusive; incorporate; incorrectly; indication; indications; infraspinatus; insurance; intermediaries; involve; involving; joint; justify; labral; labrum; leaving; lesions; limited; main; make; massive; material; maximum; mini; minor; modifier; money; multiple; muscles/tendons; musculotendinous; necessarily; nonbiological; normal; number; occasional; open; operative; opportunity; order; original; orthopedic; osteophytes; parenthetical; part; partial; patient; payment; pending; performed; performs; policy; preparation; procedure; procedures; provide; rearrangement; receive; recognize; reconstructed; reconstruction; reimbursement; reiterates; releases; removal; repair; repaired; repairing; repairs; report; reported; reporting; requiring; retraction; return; review; revised; rotator; roughly; ruptured; selection; sentence; separate; separately; series; shaving; shoulder; significant; simple; simply; size; soft; specific; stand; state; statement; stating; structures; subscapularis; supplies; support; supraspinatus; surgeon; surgeries; surgical; suturing; synthetic; system; tear; tears; technique; tendon; tendons; teres; terms; thermal; tissue; torn; true; type; typically; uncertain; underpayment; unlisted; unrelated; user; verbiage; verify; versus; visualized; warrant