“Slightly more than half of physicians will agree on the same Current Procedural Terminology (CPT)* code for a given visit, and only 60 percent of professional coders will agree on the same code for a particular visit,” according to an article published by the Southern Medical Association in 2010.† In the article, titled “Medical Decision Making: Guide to Improved CPT Coding,” author Jim Holt and colleagues discuss the intricacies of coding and the large margin for errors within medical practices.
To help navigate through these and other pitfalls of coding, each year the American College of Surgeons (ACS) hosts a series of two-day workshops on the application of changes to the CPT code set with an emphasis on codes that general surgeons commonly use. Expert instructors from the practice management consulting firm KarenZupko & Associates deliver practical explanations for each change, using real case examples and educational materials developed by the American Medical Association (AMA).
Who should attend an ACS Coding Workshop?
Surgeons, administrators, managers, coders, and reimbursement staff would all benefit from attending the workshops. Team attendance is highly encouraged, as it is vital to ensure accurate, complete, and consistent coding. Registration discounts are offered when three or more team members are enrolled at the same time. Moreover, if the physician is an ACS member, team members or practice employees may attend the workshop at the ACS member rate.
How often does coding change? Should I plan to attend a workshop each year?
Yes. Codes change frequently. In fact, the AMA updates the CPT code set annually. Improvements in coding constructs, additions of new technology, and changes to coding and reimbursement rules and payment policies make it necessary to attend a workshop annually.
What are the advantages of attending an ACS Coding Workshop?
When accurate coding is aligned with a clear understanding of payment policy rules, practices will begin to improve profit margins. Attending an ACS coding workshop increases participants’ knowledge of coding principles and helps them develop the skills needed to decrease coding errors and reduce the risk of an audit. The workshop also comprises information regarding the new codes for the year and audit trends and allows participants to practice accurate coding.
Additionally, attendees have the opportunity to share their different coding and practice management ideas, knowledge, experiences, and backgrounds with the group. Attendees also learn how their colleagues are handling coding, billing, and practice management issues.
What will I learn?
The topics discussed at an ACS coding workshop change annually due to the addition, deletion, and revision of the CPT code set. However, the focus of the first day of the workshop is on how to code correctly. Topics may include coding accurately for evaluation and management (E/M) services, reducing the risk of an audit, and new Medicare rules, regulations, and policies. These topics are addressed with an emphasis on their effects on surgical practices. Additionally, the instructors discuss how to appropriately apply coding and modifier guidelines to accurately report multiple procedure combinations. The Centers for Medicare & Medicaid Services’ Physician Quality Reporting Initiative, Electronic Health Record, and Electronic Prescribing Incentive Programs, which are updated annually, also are addressed.
The second day of the workshop is dedicated to surgical case coding. The instructor discusses the information that should be included in an operative note if a surgeon is seeking reimbursement for an operation performed with an assistant or co-surgeon. Other topics discussed include:
- Coding for excisional breast biopsy or partial mastectomy
- Coding for component separation release
- When and how to report E/M services for major and minor procedures, especially trauma
- The use of modifier 58 in wound care, lesion excision, and breast and colon surgery
- Services included in the global surgical package
- The difference between returning a patient to treat a surgical complication and a staged procedure
- Correctly document and report procedures that are unrelated to surgeries done previously in the global period
- How to initiate a successful appeal when paid incorrectly
Additional ACS coding resources
To assist surgeons in their efforts to address coding questions, the ACS also offers the following resources:
1. The Coding Hotline (1-800-227-7911), hours of operation 7:00 am–4:00 pm Mountain Time. The coding hotline will answer five free coding questions a year for each Fellow of the ACS. For additional information on the ACS coding hotline, visit the ACS website.
2. The Coding and Practice Management Corner (previously Socioeconomic Tips), a column in the Bulletin, provides tips on a range of reimbursement-related issues. The topics change monthly and in past years have included coding for hernia and other complex abdominal repairs, debridement, and sentinel lymph node mapping and its relation to biopsy. These and other articles can be found on the ACS website.
Can I earn CME for attending a workshop?
Physician attendees are eligible to receive continuing medical education (CME) credits through the ACS. Physicians are eligible for 6.5 CME credits for each day of attendance. In addition, nonphysician attendees who are members of the American Academy of Professional Coders are eligible for 6.5 CEU credits for each day of attendance.
When and where will the next ACS coding workshops take place?
- April 11–12, Hyatt Chicago Magnificent Mile, Chicago, IL
- May 16–17, Wyndham Baltimore Peabody Court, Baltimore, MD
- August 22–23, Lowes Vanderbilt Nashville, Nashville, TN
- October 24–25,The Westin Las Vegas, Las Vegas, NV
- November 7–8, Hyatt Chicago Magnificent Mile, Chicago, IL
The dates and location change each year; visit the ACS practice management Web page for the most current dates and locations.
How do I register?
The ACS offers a special price for members and their coding staffs. ACS Fellows and their staff members should be sure to have their ACS member number available and enter it for each person registering. ACS membership is not a requirement of attendance. Register for the two-day workshop online or call 312-642-8310.
For hotel reservations, contact the hotel that is hosting the workshop using the number provided during the registration process, and then indicate that you are attending the “American College of Surgeons CPT Coding Course” for special pricing.
The ACS also offers special airfare discounts on United by contacting ACS Travel Counselor Norma Velazquez at 800-456-4147 or ACSTravel@facs.org, or United Airlines at 800-521-4041 or online at www.united.com. When booking individual travel, be sure to indicate the name of the meeting and refer to the ACS file numbers provided for any applicable discounts.
Editor’s note
Accurate coding is the responsibility of the provider. This article is intended only as a resource to assist in the billing process.
*All specific references to CPT codes and descriptions are © 2012 American Medical Association. All rights reserved. CPT and CodeManager are registered trademarks of the American Medical Association.
†Holt J, Warsy A, Wright P. Medical decision making: Guide to improved CPT coding. South Med J. 2010;103(4):316-322.
