2006 OBGYN Coding Update

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2006 OBGYN Coding Update

• Steven A. Adams, CPC, CPC-H, COA

http//www.coderscentral.com/beauty.htm
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What You Want...
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What You Get...
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Topics

• 2006 RVU Update Reimbursements
• Injection Changes
• New Adhesion Code
• New Fistula Code
• New Vaginal Endoscopy Code
• New Uterus Code
• New Laboratory Code
• Resources

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Payment Reform Continues
The lovely thing about being 40 is that you can
appreciate 25 year old men more. Colleen
McCullough
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Remember
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Remember
- Embrace Optimism -
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Remember
- Embrace Optimism -
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Worthless Information?
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Rest of Georgia
99261,62 63
Atlanta, Georgia
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Sample OBGYN Reimbursements
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Call Somebody
Legislation has been introduced in the House and
the Senate that would stop these cuts. You can
help by contacting your senators and
representatives. Call our toll-free number to
speak to all of your lawmakers in one phone call.
Dial 1-866-899-4088 and enter your zip code at
the prompt. When you are directed to the first
office, ask to speak to the health legislative
assistant.
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New Injection Changes
Whatever women do they must do twice as well as
men to be thought half as good. Luckily, this is
not difficult. Charlotte Whitton
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Effective 1/1/06 Medicare No Longer Accepts
G0351
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2006 Injection Codes
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(No Transcript)
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New Injection Codes 2006

• 53.71
• 17.27
• 65.57
• 22.42
• 16.28

• 90760 - IV Hydration
• 90761 - each hour
• 90765 - IV Therapy
• 90766 - each hour
• 90772 - IM Injection

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New Intestinal Adhesion Code
When will our consciences grow so tender that we
will act to prevent human misery rather than
avenge it? Eleanor Roosevelt
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Intestinal Adhesions
44180 - 1600

• ?44180 - Laparoscopy, surgical, enterolysis
  (freeing of intestinal adhesion) (separate
  procedure)

For laparoscopy with salpingolysis ovariolysis
use 58660
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New Fistula Codes
Fear is a disease that eats away at logic and
makes man inhuman. --Marian Anderson
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Ileoanal Pouch Repair
46712 - 4000
46710 - 1900

• ?46710 - Repair of ileoanal pouch fistula/sinus
  (eg, perineal or vaginal), pouch advancement
  transperineal approach
• ? 46712 - combined transperineal and
  transabdominal approach

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New Code for Vaginal Repair
I love women, Theyre the best thing ever
created. If they want to be like men and come
down to our level, thats fine. Mel Gibson
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Vaginal Repair
57295 - 1000

• ?57295 - Revision (including removal) of
  prosthetic vaginal graft, vaginal approach

Graft removal is included in the code
Pt with past hx of colpopexy with mesh 1 year ago
presents with mesh eroding through the apex of
the vagina
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New Vaginal Endoscopy Code Revision
My husband and I didnt sign a pre-nuptial
agreement. We signed a mutual suicide
pact. Rosanne Barr
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Vaginal Endoscopy
57421 - 300

• ?57421 - Colposcopy of the entire vagina, with
  cervix if present, with biopsy(s) of vagina/cervix

For endometrial sampling with colpo 58110 -
Endometrial sampling with colposcopy
Code has been revised to clarify that an
endometrial biopsy is not included in this code
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Corpus Uteri Excision
My wife and I were happy for ten years. Then we
met. Rodney Dangerfield
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Endometrial Biopsy Code
58110 - 150

• ?58110 - Endometrial sampling (biopsy) performed
  in conjunction with colposcopy (list separately
  in addition to code for primary procedure)

Report with 57420 - Colposcopy of vagina
85 57421 - Colposcopy of vagina, with biopsy
119 57452 - Colpo of the cervix 84 57454 -
with biopsy endocervical curettage 130 57455 -
with biopsy of the cervix 107 57456 - with
endocervical curettage 100 57460 - with loop
electrode biopsy 157 57461 - with loop
electrode conization 184
Colpo of Cervix with endocervical curettage and
an endometrial biopsy 57456 58110
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New Laboratory Codes

• To be successful, a woman has to be much better
  at her job than a man.
• Golda Meir

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Common Code Changes

• Occult Blood (guaiac)
• ? 82270 - 3 cards/triple card
• 82271 - other sources
• 82272 - single specimen

• Hemoglobin
• ? 83036 - A1C
• 83037 - A1C by FDA device

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Topics

• 2006 RVU Update Reimbursements
• Injection Changes
• New Adhesion Code
• New Fistula Code
• New Vaginal Endoscopy Code
• New Uterus Code
• New Laboratory Code
• Resources

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Resources

• coderscentral.com
• cms.gov
• practice-management.org
• gamedicare.com
• oig.hhs.gov/publications/workplan.html
• cms.hhs.gov/medlearn/matters/mmarticles/2005/SE054
  3.pdf
• cms.hhs.gov/physicians/cciedits/default.asp
• medville.com

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How Do I Remember All This Stuff?
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You Cant
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Remember
That little barking dog chasing your car down the
street actually thinks hes chasing you out of
his neighborhood. Steven Adams
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• Questions?