Again, as in past updates, you get separate coding guidelines for physician services and outpatient hospital services—still the only product on the market with this feature!

Some of the many highlights to look for in the Q2 2003 version—

Ophthalmology outpatient procedures—Coding paracentesis of the anterior chamber doesn’t happen frequently because it’s usually included in other eye procedures. But there are at least four cases where it can be reported separately. Find the answers in the coding notes and procedure examples at 65800-65815.

Common glaucoma procedures—Learn the one key difference between Goniotomy (65820) and trabeculotomy (65850) that will help you choose the correct code.

And look for new coding notes at trabeculectomy (66170-66172). Both of these high volume outpatient procedures can involve the use of antifibrotic agents so don’t base your coding on that factor. Check these procedures for specific guidance.

Laser iridoplasty—how to distinguish it from laser iridotomy.

Laser destruction of an iris lesion or laser iridotomy? We explain the unique circumstances when both procedures can be performed at the same session but only one can be reported.

Vertebral body biopsy—with the increase in certain communicable diseases and infections, this open procedure is performed more frequently now. The surgical approach can vary by spinal level.

Common injuries—sports injuries, burns, trauma to the leg—can require decompression fasciotomy—learn which of 6 different fasciotomy codes to use in each specific case. With debridement or without debridement? One or more compartments released? Look for clear coding guidelines, descriptions of each leg compartment, and procedure examples that help you choose among the 6 codes for the right code assignment. (27600-27602 and 27892-27894)

These codes also alert you to look for compartment pressure measurement in the fasciotomy operative report. An often-missed, but billable procedure, "compartment pressure measurement," (20950) has been added with its own coding tips that tell you when you can bill it in addition to a fasciotomy code!

When can the outpatient radiology department and the radiologist bill a chest x-ray in addition to a bone biopsy of ribs? Check the notes at 20240 to capture this important information.

And, a reminder that additional coding and clinical support is always available in the unique "Understanding…" sections that focus on common, but complex, coding issues. For answers to your questions, simply search to find the one you need to know more about. Here’s a complete list:

Understanding the Next Four Sections (Codes 14000 - 15770): Important Concepts of Tissue Transplantation Procedures

Flaps (Skin and/or Deep Tissues): Understanding Important Concepts about Flaps Codes 15570 - 15770

Understanding Important Concepts of Chemosurgery (Mohs Micrographic Technique) (Codes 17304 - 17310)

Understanding Important Coding Concepts for Musculoskeletal System Procedures

Understanding Important Coding Concepts for Nasal/Sinus Endoscopic Surgery

Understanding Important Coding Concepts: Endovascular Aneurysm Repair

Understanding Important Concepts for Spine and Spinal Cord Pain Management Procedures

Understanding Important Concepts for Extracranial Nerves, Peripheral Nerves, and Autonomic Nervous System Pain Management Procedures

Understanding Important Coding Concepts for Strabismus Surgery (Codes 67311 — 67343)

For Physician Services

Understanding Important Coding Concepts for Strabismus Surgery (Codes 67311—67343)

For APC/Outpatient Hospital Facility Services

Understanding Important Concepts for Coding "Diagnostic Radiology (Diagnostic Imaging)" and "Diagnostic Ultrasound" Services

Understanding Important Concepts for Intracoronary Stent Placement and Percutaneous Transluminal Coronary Balloon Angioplasty (PTCA) Procedures