Very often for patients being treated for orthopedic trauma have additional injuries that need to be considered for the treatment planning, including many trips to the operating room, By utilizing modifiers correctly, the surgeon can be reimbursed for all of the services performed. There are also insurance carrier hurdles that have to be jumped due to liability in these injuries for responsibility of the charges. This has an impact on the coding based on different carrier guidelines.
This session by Lynn Anderanin, CPC, CPC-I, COSC, will be of real cases representing common injuries and treatment for future reference for the attendees This conference will not only look at cases utilizing CPT codes from the musculoskeletal system, but also other body systems like integumentary, cardiovascular, and nervous system.
There are additional points to consider when coding orthopedic trauma cases vs. elective orthopedic cases due to the condition of the patient at the time treatment is planned and the complexity of the injuries that patient has. Modifiers become critical when the patient requires multiple surgeries for the treatment in order for proper reimbursement, as well as properly identifying the different body systems involved and treated. Often, trauma cases are the result of motor vehicle accidents, for example. Because of this, considerations have to be made as to what insurance carrier is potentially responsible for the claims, and special coverage limits that may be in place. Claim forms also require additional information to identify the accident, and if omitted, may cause claim denials. This will be addressed as it can cause a delay in reimbursement if not provided.
Who should attend : Orthopedic surgeons, hand surgeons, non physician providers, coders, collections staff, surgery schedulers, practice managers/administrators.
Lynn 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,...
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