Interpreting Surgical Guidelines from the NCCI Policy Manual

Event Information
Product Format
Prerecorded Event
60 minutes
Product Description

Avoid Misrepresenting Services & Overpayment by Adhering to NCCI Medicare Guidelines

As every coder and biller knows, CMS updates the National Correct Coding Initiative (NCCI) Policy Manual every year. Instead of thinking about the manual as the government’s way of complicating and preventing payment, what if we recast it as a way to help you do your job better? Aside from the small changes we get from year to year, the NCCI is a fact of life – so let’s make it a source of joy instead of pain.

When it comes to the surgical guidelines in the NCCI Policy Manual, physicians and their coding and billing staff need to understand that the goal is not to prevent them from being paid – it’s to prevent two payments for only one service. And while the requirement is to choose the most specific code, it’s not always easy to know when you’re unbundling. Evaluation/management services are integral to the surgical code – is your staff handling this tricky area correctly?

This session with expert speaker Christopher Chandler will educate you on the nuances of the NCCI Policy Manual related to surgical coding. It will cover the specific services included in the surgical global package, along with the details regarding appropriate billing within the global period. Specifics of the presentation include the correct use of surgical modifiers, appropriate times to use “separate procedure” codes, coding biopsies with more extensive procedures, reporting evaluation and management services with surgeries, and more surgery coding concepts from the NCCI Policy Manual.

By attending this event, you will learn the correct coding guidelines from Medicare’s policy manual. You will gain details of the coding system and the reasoning for these guidelines. This knowledge will help you provide better patient care through thorough documentation and accurate coding. It will help you reduce denials and avoid risk.

Session Highlights

  • Services included in the surgical global package
  • Correct billing within the surgical global period
  • How to avoid unbundling codes
  • When to report “separate procedure” codes
  • Coding biopsies with more extensive procedures
  • When to report both an evaluation and management code and a surgery code
  • Correct use of surgical modifiers 22, 24, 25, and 57

Session Agenda

  • What is the NCCI Manual?
  • How does it help?
  • Codè selection
  • Evaluation and management
  • Multiple procedure overlap
  • Unbundling
  • Inherent services
  • Separate procedures
  • Exploration of surgical fìeld
  • Lysis of adhesions
  • Endoscopic procedures
  • Fluoroscopy
  • Biopsy w/ other procedure
  • Anesthesìa
  • Modifiers
  • Medically unlikely edits (MUEs)

Who should attend

  • Surgeons
  • Certified Coders
  • Practice Managers
  • Billing Staff

At the Q&A session following the live event, ask a question and get advice unique to your situation, directly from our expert speaker.

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About Our Speaker

Christopher Chandler


As a Professional Coding Consultant for Intermountain Healthcare, Christopher regularly consults, educates and presents to providers, staff, managers and operations officers regarding coding guidelines and payer policies. He specializes in General Surgery, Trauma Surgery, Breast Surgery, and Podiatry. He has been a featured guest for the Healthicity compliance podcasts and webinars, and was a speaker at AAPC’s Healthcon. He teaches the medical coding class as an adjunct professor...   More Info
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