Utilizing CPT And ICD-10-CM For Coding Orthopedic Complications

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Surgery for patients does not always go as planned and some specific codes and modifiers are used to tell the story of orthopedic complications. It is important to understand correct coding when complications occur, especially in the postoperative period, to obtain the correct reimbursement in this sometimes-complex procedure(s). The claims sent to insurance companies must be clear in telling the story of the patient and what had been done to help in the recovery process which can sometimes take months. We will talk about many of the circumstances that can happen to delay a patient’s healing, and how we code these problem cases.

Learning Objective:

• CPT coding for complications
• The use of Sequela in ICD-10-CM
• Recommendations for providers for better documentation
• Other ICD-10-CM codes that may need to be assigned
• Proper use of modifiers for complications

Areas Covered in the Session:

• CPT codes that are specifically for complications
• Appropriate modifiers for multiple surgeries in the postoperative period
• Different methods of treating complications
• ICD-10 codes to use for secondary surgeries
• Tips for working with providers for better documentation
• Live Q&A Session

Suggested Attendees:

• Billers
• Coders
• Administrators
• Managers
• Physicians
• Physician Assistants
• Revenue Cycle Staff
• Claims Adjusters
• Surgery Schedulers
• Caseworkers
• Nurses
• Reimbursement Staff
• Qualified Healthcare Professionals
• Practice Manager
• Insurance Claim Processors
• Reimbursement Specialist and Staff
• Non-Physician Practitioners

Presenter Biography:

Lynn M. Anderanin, CPC, CPB, CPMA, CPC-I, CPPM, COSC is the Sr. Coding Educator for Healthcare Information Services, a revenue cycle management and consulting service in the Chicagoland area. Prior to relocating to Chicago, Lynn was the Billing Office Manager and surgical coder for Hand Surgery Associates, now Michigan Surgery Specialists in the Detroit Area.  She has over 39 years of experience in all areas of the physician practice including Practice Administrator, Billing Manager, and Director of Operations.  Her experience is primarily in the specialties of Orthopaedics, Rheumatology, and Hematology/Oncology. She has been a speaker for many conferences, including the AAPC National Conferences and Workshops, Community Colleges, Audio Conferences, Certification classes, and Webinars. Lynn became a CPC in 1993, a Certified Instructor in 2002, a Certified Orthopedic Surgery Coder in 2009, an examination in which she participated in creating. She passed the Certified Practice Manager exam in 2015, the Certified Medical Auditor exam in 2016, and the Certified Professional Biller exam in 2021. Lynn is the founder of the first local chapter of the AAPC in Chicago, which is now 25 years old, and a former member of the AAPC National Advisory Board as well as several other committees for the AAPC.

Snippet From Our Previous Session