Surgery Guidelines

Question 1

Surgery Section Divided By?

Answer 1

subspecialty

Question 2

When are unlisted procedure codes used?

Answer 2

only when a more specific cat 1 or at 3 code not available

Question 3

What must be sent with an unlisted code

Answer 3

special report

Question 4

What must a special report contain?

Answer 4

description of the nature, extent, and need for the procedure, and the time, effort and equipment necessary

Question 5

separate procedure codes are

Answer 5

Minor procedures reported only when they are the only service performed or when they are performed with another major surgery but on a different side or unrelated procedure

Question 6

Nothing bundled with

Answer 6

minor procedure

Question 7

who decides whats included in the surgical package

Answer 7

third party payers

Question 8

major surgical packages usually include

Answer 8

preop
intraop
postop
minor complications

Question 9

Modifier for unplanned return to the operating room, same provider

Answer 9

-78

Question 10

Never included in surgery bundle

Answer 10

general anesthesia

Question 11

decision for surgery

Answer 11

-57

Question 12

modifier for a procedure on the same date at an e/m (significant, separately, identifiable)

Answer 12

-25

Question 13

Needles, suture materials, wipes, drugs

Answer 13

surgical tray

Question 14

exacerbation

Answer 14

worsening

Question 15

predefined dates before and after a surgical procedure

Answer 15

global period

Question 16

Subsections of surgery section divided according to

Answer 16

Body System or Specialty

Question 17

dehiscence

Answer 17

splitting open of surgical wound