Joint replacements and arthroscopic surgery are two areas that insurance carriers spend a lot in reimbursement for their members. Because of this, insurance carriers are continually changing guidelines and policies on the coverage of these procedures. Center for Medicare or Medicaid Services (CMS) recognizes that joint replacement surgery is reserved for patients whose symptoms have not responded to other treatments. To avoid denial of claims for major joint replacement surgery, the medical records should contain enough detailed information to support the determination that major joint replacement surgery was reasonable and necessary for the patient.
During the past years, the number of arthroscopies for knee, shoulder, and hip conditions has increased significantly due to which it is very important to address the reporting needs of these procedures. However, the fact that CPT is only updated annually, have resulted in codes that lag behind common techniques. This in turn, has created a lot of confusion among healthcare practitioners and coders about how to correctly code and bill for these services. This webinar will review the coding for arthroscopy and replacement in the hip and knee.
- Understand the current NCCI edits and policy manual guidelines related to arthroscopy.
- Gain knowledge of how to apply CPT codes and modifiers to cases related to infections of joint prosthesis
- Consider new and emerging technology and best practices for coding computer assisted navigation, subchondroplasty, and the use of robotics for surgery.
- See commercial policies on these procedures and what is required to ensure reimbursement
Areas Covered in the Session:
- Knee arthroscopy and coding by compartment
- Hip arthroscopy with a look at procedures currently being performed that do not have CPT code assignments
- What to report for robotic surgery, custom knee prosthesis, and computer assisted navigational procedures
- Proper coding of complications related to joint prosthesis to include removal and replacement of joint spacers and antibiotic devices.
- Live Q&A Session
- Medical Assistants
- Claims Processors
- Anyone involved with Orthopedic Surgeons
About the Presenter:
Lynn M. Anderanin, CPC, CPMA, CPPM, CPC-I, COSC, is the Sr. Director of Coding Education for Healthcare Information Services, a physicians revenue cycle management company. She has over 35 years experience in all areas of the physician practice, and specializes in Orthopaedics. Lynn is currently a workshop and audio presenter. She is a former member of the American Academy of Professional Coders (AAPC) National Advisory Board and has served on several other boards for the AAPC. She is also the founder of her local chapter of the AAPC.
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