Learn the Ins and Outs of Add-on Codes to Ensure Payable Claims

Posted on 12. Mar, 2010 by Editor.

Knowing how to use add-on codes can net you up to $258 in additional reimbursement.

CPT is full of “add-on” codes, additions to minor and major surgical procedures as well as to E/M services. Fortunately for urology there are not many “add-on codes,” but that makes it essential for you to know the special rules that apply to these codes when you do have to use them. If you learn just a few main guidelines, you can gain the best possible reimbursement for your urologist’s procedures including all add-on codes.

Look for the ‘+’ Symbol

There’s an easy way to tell if a CPT code is designated as an add-on code…

Continue Reading

Don’t Mesh Up Your +57267 Coding

Posted on 13. Sep, 2009 by .

An ob-gyn doc with coding know-how tells us how to clean up our mesh claims.

Thinking of using +57267 (Insertion of mesh or other prosthesis for repair of pelvic floor defect …)? Given that +57267 can get you about $260 more, it’s a good move to consider for some claims — as long as you understand how to use it correctly.

The +57267 mesh add-on code is meant to capture “additional work for putting in mesh grafts where [mesh] is optional,” according to Dr. Harry Stuber, who spoke at an Ob-Gyn Specialty Coding & Billing Conference in Orlando. “If the procedure ALWAYS uses mesh (for example, sling, sacral colpopexy), it’s already been valued in the RVU. Don’t bill extra,” Dr. Stuber explains.

So when can you use +57267?

The answer is ‘NO’ for sling, sacral colpopexy.

But the answer is potentially ‘YES’ for anterior repair, posterior repair, paravaginal repair (that’s a new change), retrocele repair and hernia repair, incisional (use +57267 once for each site), Dr. Stuber says.

Medical necessity note: Don’t use cystocele or retrocele ICD-9 codes, Dr. Stuber warns. For weak fascia, consider 618.03 for pubocervical or 618.04 for rectovaginal. Tip: Make sure the physician has described fascia status in the op note.

Don’t miss the next Ob-Gyn Specialty Coding Conference in Orlando, this December 6-8.

Continue Reading

What a Mesh! (+57267)

Posted on 09. Mar, 2009 by .

Take this advice to avoid messing up your mesh coding: CPT +57267 is an add-on code meant to bill for additional work putting in mesh grafts for procedures where mesh is optional, says Dr. Harry Stuber, who’s teaching at the Coding Institute’s Ob-Gyn Specialty Coding Conference in July.

If the procedure always uses mesh (sling or sacral colpopexy, for example), the mesh is already in the RVU. Don’t use +57267 to bill extra, Dr. Stuber warns.

Continue Reading