Article Type
Changed
Tue, 08/28/2018 - 10:53
Display Headline
2 procedures in 10 days will trigger bundling

Q Our patient is scheduled for a cesarean delivery, but the surgeon wants to excise a large keloid scar prior to the cesarean. How should this be coded?

A I am not sure by your question of the sequence or timing of events.

If the physician is taking the patient to surgery to do only the keloid excision, you have several codes to select from, depending on the type of closure. The excision of the keloid scar would be reported using 11400–11406 (Excision, benign lesion including margins, except skin tag [unless listed elsewhere], trunk, arms or legs), where the code selected depends on the documented size of the scar removed.

If it is simple closure, no additional code is reported, but if the closure is either intermediate or complex, you will add a code from the repair section (12031–12037 or 13100–13102). But again the size in centimeters must be documented in order to use these codes.

Also remember that if the surgeon performs the cesarean within 10 days of the keloid excision, he/she will be in the global period for these codes and might have to use a modifier -79 (Unrelated procedure or service by the same physician during the postoperative period) on the global OB code you report. If the keloid is excised at the time of the cesarean, it will be included by most payers as part of establishing the operative site and incision closure.

Article PDF
Author and Disclosure Information

Melanie Witt, RN, CPC-OGS, MA
Independent coding and documentation consultant; former program manager, Department of Coding and Nomenclature, American College of Obstetricians and Gynecologists

Issue
OBG Management - 18(11)
Publications
Topics
Page Number
85-86
Sections
Author and Disclosure Information

Melanie Witt, RN, CPC-OGS, MA
Independent coding and documentation consultant; former program manager, Department of Coding and Nomenclature, American College of Obstetricians and Gynecologists

Author and Disclosure Information

Melanie Witt, RN, CPC-OGS, MA
Independent coding and documentation consultant; former program manager, Department of Coding and Nomenclature, American College of Obstetricians and Gynecologists

Article PDF
Article PDF

Q Our patient is scheduled for a cesarean delivery, but the surgeon wants to excise a large keloid scar prior to the cesarean. How should this be coded?

A I am not sure by your question of the sequence or timing of events.

If the physician is taking the patient to surgery to do only the keloid excision, you have several codes to select from, depending on the type of closure. The excision of the keloid scar would be reported using 11400–11406 (Excision, benign lesion including margins, except skin tag [unless listed elsewhere], trunk, arms or legs), where the code selected depends on the documented size of the scar removed.

If it is simple closure, no additional code is reported, but if the closure is either intermediate or complex, you will add a code from the repair section (12031–12037 or 13100–13102). But again the size in centimeters must be documented in order to use these codes.

Also remember that if the surgeon performs the cesarean within 10 days of the keloid excision, he/she will be in the global period for these codes and might have to use a modifier -79 (Unrelated procedure or service by the same physician during the postoperative period) on the global OB code you report. If the keloid is excised at the time of the cesarean, it will be included by most payers as part of establishing the operative site and incision closure.

Q Our patient is scheduled for a cesarean delivery, but the surgeon wants to excise a large keloid scar prior to the cesarean. How should this be coded?

A I am not sure by your question of the sequence or timing of events.

If the physician is taking the patient to surgery to do only the keloid excision, you have several codes to select from, depending on the type of closure. The excision of the keloid scar would be reported using 11400–11406 (Excision, benign lesion including margins, except skin tag [unless listed elsewhere], trunk, arms or legs), where the code selected depends on the documented size of the scar removed.

If it is simple closure, no additional code is reported, but if the closure is either intermediate or complex, you will add a code from the repair section (12031–12037 or 13100–13102). But again the size in centimeters must be documented in order to use these codes.

Also remember that if the surgeon performs the cesarean within 10 days of the keloid excision, he/she will be in the global period for these codes and might have to use a modifier -79 (Unrelated procedure or service by the same physician during the postoperative period) on the global OB code you report. If the keloid is excised at the time of the cesarean, it will be included by most payers as part of establishing the operative site and incision closure.

Issue
OBG Management - 18(11)
Issue
OBG Management - 18(11)
Page Number
85-86
Page Number
85-86
Publications
Publications
Topics
Article Type
Display Headline
2 procedures in 10 days will trigger bundling
Display Headline
2 procedures in 10 days will trigger bundling
Sections
Article Source

PURLs Copyright

Inside the Article

Article PDF Media