Shoulder Procedures CPT Coding Part 2 - Understanding Code Reporting and Associated Edits

Instructor

Amanda Register, RHIT, CCS, CDIP 

Description

This course delves into the intricacies of coding shoulder procedures using the Current Procedural Terminology (CPT) system. Building on the knowledge gained in Part 1 of the series, participants will gain a deep understanding of the National Correct Coding Initiative (NCCI) edits, which significantly impact the reporting of multiple shoulder CPT procedures. The course covers essential topics such as modifiers and key coding challenges, all while providing official coding guidance and references. Topics explored include updated shoulder procedure CPT codes, anesthesia rules, distinctions between procedures like synovectomy and debridement, and the complex world of SLAP lesions. Additionally, the course sheds light on unique procedures like autologous ADRC therapy for partial thickness rotator cuff repair.

**Note: The pre-requisite for this course is Shoulder Procedures CPT Coding Part 1.

Included Lessons:

• Introduction
• Updated Shoulder Procedure CPT Codes
• National Correct Coding Initiative
• Coding Clinic References Regarding NCCI Edits
• CPT Coding Challenges
• CPT Assistants/Coding Clinic for HCPCS Pertaining to Shoulder Arthroscopies and Associated Procedures

Key Takeaways

• Understanding of NCCI Edits: Coders will have a solid grasp of the National Correct Coding Initiative (NCCI) edits, which play a crucial role in determining which code combinations should not be reported together. This knowledge is essential for preventing incorrect payments and claim denials.
• Proficiency in Modifier Usage: Participants will be well-versed in the appropriate use of modifiers to accurately report procedures when exceptions apply. This skill is vital for ensuring accurate reimbursement and compliant coding.
• Updated CPT Code Knowledge: Coders will stay up-to-date with the latest CPT codes related to shoulder procedures, including any recent changes or updates, such as those related to the removal of loose bodies or foreign bodies.
• Differentiation of Procedures: The course provides guidance on distinguishing between various shoulder procedures, such as debridement, synovectomy, and SLAP lesion repairs. Coders will learn how to accurately code each procedure type based on the specifics of the case.
• Insight into Anesthesia Rules: Coders will gain an understanding of anesthesia rules, including when separate payment for anesthesia is allowed and when it is bundled with the surgical procedure.
• Knowledge of Uncommon Procedures: Coders will be equipped to handle less common procedures, such as autologous ADRC therapy for partial thickness rotator cuff repair, and will know how to assign the appropriate codes for such cases. 
• Knowledge of Special Cases: Coders will be prepared to handle special cases, such as the reporting of procedures involving distal clavicle resection, thermal capsulorrhaphy, and SLAP lesions of different types.

Benefits of Taking this Course

• Enhanced Coding Accuracy
• Increased Coding Efficiency
• Reduced Claim Denials
• Up-to-Date CPT Code Knowledge
• Proficiency in Modifier Usage
• Specialized Shoulder Procedure Skills

FAQs

About our Medical Coding Courses

HIAlearn, powered by Health Information Associates (HIA)—a leader in medical coding and auditing for more than three decades—offers a comprehensive online education platform for medical coders. With a catalog of over 200 medical coding courses accepted by the American Health Information Management Association (AHIMA) for Continuing Education Units (CEUs) and a selection approved by the American Academy of Professional Coders (AAPC), HIAlearn caters to both beginners and experienced medical coders seeking to enhance their skills. The platform provides an array of training plans tailored to meet individual learning needs, from mastering challenging coding procedures to understanding broad conceptual frameworks within the coding world. Courses are available across various coding types including CPT, E/M, ICD-10-CM, ICD-10-PCS, and are designed to cater to different coder levels and coding specialties such as inpatient, outpatient, profee, and CDI. Additionally, HIAlearn offers a Coding Updates bundle to ensure coders are up-to-date with the annual changes in ICD-10-CM, ICD-10-PCS, CPT, and IPPS. Beyond individual learning, HIAlearn supports organizations with group discounts, promoting enhanced coding accuracy, efficiency, and compliance across teams.