Separate Procedures – CPT Medical Coding – Video

Laureen: Yes, nice segue. The last slide and my next slide is on separate procedures.

Q:  Could you review “separate procedure” and give some examples?

A:  Yes. I can.“Separate procedure” is a convention used in CPT basically to tell us that, “Hey! This procedure is normally included in other bigger procedures, so just be careful if you’re going to be reporting me” so just kind of view it as a heads up. Oftentimes, it has its own code because it can be done by itself; but because it’s commonly done with other larger procedures like part of the approach, it’s bundled in so they give you that separate procedure phrase at the end of the CPT description to let you know that.

You might have a special circumstance where that would allow you to report it separately, that’s okay, but again it’s just kind of beware type thing, “Danger Will Robinson!” really dating myself. We should do a poll to see how many people remember references to those shows. I had to change teaching, I used to teach and say, “The Quincy codes,” now I have to say “the CSI codes” because my class looked at me, like, “Quincy? What are you talking about?”

Separate Procedures – CPT- Medical Coding – Video

If that is the only code that you’re getting ready to put on your claim form, chances are it’s safe to use it. There’s not a bundling issue because there’s no other codes. But if you have another procedure on the claim, you really want to make sure that it’s not part of it and the best way to do that is to do a CCI check using your software or going to the CMS website and using it.

A good example, they asked for an example, this is what I use often when I’m teaching is from my own experience, I had my left ovary removed. I had to go in for an emergency surgery and they did an oophorectomy (58940)…

By the way, do you guys love to impress your doctors when they’re asking your history and you don’t say, “I had my ovary removed,” you say, “I had an oophorectomy.” They’re like, “Oh! Are you a nurse?” “No, I’m a coder.”

Alicia: I always say “Better.”

Laureen: There you go. An oophorectomy if it’s an open procedure, they have to cut the abdomen and do a laparotomy to go to get the organ and remove it. That laparotomy which is coded on its own is 49000 is bundled into the oophorectomy, and therefore if you look at the CPT code in its full glory in the CPT manual, at the very end, in parentheses it says, “…separate procedure.” Just giving you a heads up that, “Yo! I’m probably included in something else you may be reported, so be careful.”

Now, if you want to be absolutely sure, pop your codes into your CCI checker. I use FindACode.com. And if you scroll down a little bit, Alicia, you’ll see I did a screenshot of the results and you can see sure enough, I have 49000 showing an error and in red it says, “NCCI Edit exists with the 58940.” It’s basically saying that the 49000 is part and parcel of the oophorectomy so you can’t bill both of them. OK?

Now, this is where I wanted to teach you how to fish. Now, all of that, that I just said, came from my own head. That just happens to be something that I know. But when I don’t know something or I want to provide extra resources, if you could pull up Google page, just go to Google.com. This will work for anything, it does not have to be just coding.

This is a trick I learned in learning how to position our website better and doing kind of internet marketing, if you type in your phrase, so we’re going to type in “separate procedure.” Now, if you just hit enter, it’s going to search Google normally, but now what I’ll want to do is say, “Let me search just CCO.” So, now you’re going to do a space and type the word ‘site’ meaning like website, and colon and right next to the colon, don’t put a space, type your site, type in cco.us.

Alicia: Our new domain.

Laureen: Our new domain.

Alicia: And enter?

Laureen:  Yes. And then hit enter. What this is doing is it’s showing you all of these areas on our site alone where we talked about separate procedure. It’s a neat way to, you don’t have to search all of Google land; you could go specific sites. Another one that I always go to is AAPC.com; so now if you change the site from cco.us to AAPC.com, you’ll see right there was the second one where it says, “January 19, 2015,” that’s fairly recent and of course with coding, I want to make sure that we’re reading something recent.

If you click on that link, it takes you right to the AAPC, the news section of AAPC, and I don’t know about you, but I get so much email, I don’t always read a lot of the new stuff from AAPC or other coding sites, so this is very helpful. If I know that that site tends to have what I need, like, I go to Supercoder.com and things like that, I’ll just focus my Google search on just that site.

John Verhovshek, I know him very well, he’s a great writer and he’s now a CPC. Started off as a writer and did writing for coding and then became a CPC; so this is a great article. He gives some examples of his own; he goes into really good detail. I just wanted to share that to be in lined with the “teach people how to fish” concept. I hope you enjoyed that. It’s site, colon, and then the website name. [Ed. Note:  For example:  site:aapc.com ]You don’t need the http, just put aapc.com, cco.us, whatever your favorite coding website is to search, and that should help you.

If you know you saw something on AAPC on maybe the CRC coding. Type in: “CRC credential site:aapc.com” and you’ll see everywhere where it’s being talked about on the discussion board, on their official websites, maybe a news article. It’s really a great tool, so hopefully that will help you.

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