Surgeries

Question 1

types of surgical procedures

Answer 1

• Prophylactic treatment: to prevent a condition from developing
• Diagnostic procedure: so the physician can gather more details about a condition or concern at issue
• Therapeutic procedure: to correct or fix a problem

Question 2

types of surgical approaches

Answer 2

1. Non-invasive or external approach (shave biopsy)
2. Minimally invasive approach (wart excision)
3. Percutaneous approach (needle biopsy)
4. Percutaneous endoscopic approach (diagnostic endoscopy)
5. Via natural or artificial opening approach (flexible esophagoscopy)
6. Via natural or artificial opening endoscopic approach (colonoscopy)
7. Open approach (appendectomy)

Question 3

services included in the surgical package

Answer 3

1. E&M
2. Anesthesia
3. The operation itself along with any service considered as part of the procedure being performed
4. Immediate postoperative care
5. Follow-up care
6. Supplies/consumables

Question 4

services excluded from the surgical package

Answer 4

1. Diagnostic tests and procedures
2. Postoperative therapies
3. A more comprehensive version of the original procedure
4. Staged or multipart procedures
5. Management of postoperative complications that require additional surgery
6. Unrelated surgical procedure during the postoperative period
7. Some supplies (casting, splint, drug)

Question 5

global period time frames

Answer 5

• Zero-day postoperative period: for endoscopies and some minor procedures whereas no preoperative period, no postoperative period, or visit on the day of the procedure is not payable as a separate service
• 10-day postoperative period: for other minor procedures 10 days following the day of surgery whereas no preoperative period, a visit on the day of the procedure is not payable as a separate service
• 90-day postoperative period: for major procedures whereas 1 day preoperative included and the day of the procedure is not payable as a separate service

Question 6

unusual services and treatments

Answer 6

• Treatment plan provided by more than one physician: we can add modifiers 54 surgical care only, 55 postoperative mgt, or 56 preoperative mgt only to report the additional services
• For increased procedural services you may add modifier 22
• Separate procedure

Question 7

examples of digestive surgeries

Answer 7

• Endoscopic procedures
• Gastric intubation
• Hernia repair
• Bariatric surgery

Question 8

examples of integumentary (skin) surgeries

Answer 8

• Incision and drainage
• Biopsies (FNA, excisional, endoscopic)
• Excision
• Re-excision
• Skin replacement and flap

Question 9

examples of musculoskeletal surgeries

Answer 9

• Cast application
• Fracture reduction
• Open or closed treatment
• Bone grafts and implants

Question 10

examples of respiratory surgeries

Answer 10

• Sinus endoscopy
• Pleural and lung biopsies
• Percutaneous needle
• Thoracotomy with biopsy

Question 11

examples of cardiovascular surgeries

Answer 11

• Pacemaker
• Implantable defibrillator
• Bypass grafting
• Cardiac catheterization with stent