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AAPC Phoenix, AZ Local Chapter
Grand Canyon Coders
Minutes for May 8, 2008
Attendees: 50 AAPC Members, 6 guests
President Kevin Solinsky called the meeting to order at 6:00pm and welcomed everyone.
Kevin introduced chapter officers and guests and members were welcomed. All the guests to the meeting were asked to introduce themselves and give their specialty. Kevin then asked for new certifications. Robert Kiesecker received his specialty credential in cardiology.
Kevin explained that this was Spring to your AAPC local Chapter month. This is 1 of 2 opportunities to be recognized by National. National has given us some pens and post-it notes as well as AAPC bucks that will be given out during the presentation.
The speaker and topic for the night had to be changed because of a death in the family. We will try to get her back on the schedule in the future as MRSA is a hot topic. Susan Ward will do a presentation on Integumentary System.
Minutes: Minutes for the April 10, 2008 meeting were reviewed. Connie McHugh made a motion to approve the minutes as submitted. Susan Ward seconded the motion and the motion passed unanimously.
REPORTS:
Motion to accept the treasurers report was made by Kathleen Perkins-Lee. Cindie Enriquez seconded the motion and the motion passed unanimously.
ArMA Update: Connie McHugh, LPN, CPC, CPC-H
You should be expecting a 10.1% deficit reduction decrease in Medicare reimbursement in June. On the state level ArMA is filing 180 state bills, a very busy season. Contact Connie for more information. The Radiology Bill was introduced last fall and the language has been changed to allow ownership of radiology equipment if you are licensed to properly order and perform for medical necessity in accordance with your licensure. Services cannot be performed primarily for economic gain.
The ICA has released their proposed changes for the year. If you want ArMA to work with you to implement changes to the ICA rules or fee schedule contact Connie.
NPI drop dead date is May 23, 2008 for Medicare and sponsored plans. Box 17 is necessary with Medicare.
MRSA diagnosis codes should be listed after the location code of the infection, C&S report result, and sepsis/septicemia codes.
OLD BUSINESS:
Update on the local conference. Registration currently stands at about 200. This is a little bit behind last years numbers. E-mails were sent out again by AAPC for the local chapter conference to every AAPC member in the state of Arizona. And this time the e-mails were also sent to the surrounding states. The chapter needs help at the seminar in several areas so if you are available to help you sign up on the sign up sheet. Speakers are confirmed and some of the presentations have been received. The next seminar meeting is scheduled for May 17, 2008 at Micki Belanus house at 2:00pm. This will be the last seminar meeting. The Hyatt has opened up more rooms at the $105 rate. There will be a 10th Annual celebration Saturday night with cake, DJ and a cash bar.
NEW BUSINESS: There will be no chapter meeting in June.
JOB BOARD: None
ROUND TABLE DISCUSSION:
Discussion took place if there was a quantity limit on nuclear treadmills being done on multiple dates for medical necessity and where it could be found in Medicare policy.
There was also a discussion regarding a review company reversing the order on multiple surgical procedures, placing the lowest paying first and reducing the higher paying codes as multiple procedures. Although it is not written anywhere it has always been the standard to list and pay the highest paying procedure first and the lesser codes are reduced as multiple procedures. Medicare has a guideline but ICA only states to list primary procedure first but no definition of primary procedure. CPT states major procedure first. ArMA will request that the ICA add the correct verbiage to their definitions to alleviate this problem.
EDUCATION (1.5 CEUs)
Integumentary System Presented by Susan Ward, CPC, CPC-H, CPC-I
The primary biopsy is coded 11100 and each additional lesion biopsy should be coded separately with add on code 11101. Add on codes do not require a modifier. Punch biopsies done on the lips, eyelids and outer ears have different codes. Punch biopsies have no global period and follow-ups can be billed. When measuring an excised lesion the margins should be included in that measurement. Closure of a wound with derma-bond (superglue) is considered and coded as a simple closure. Multiple wounds classified to the same CPT should be added in length for wound closure. Lesion excision is included in flap closures. You should bill separately when skin graft, intermediate or complex closure is required after lesion excision. Breast reconstruction can include alteration to the opposite breast for asymmetry.
July meeting will be on 7/10/08 @ 6:00pm. There will be no meeting in June because of Nationals in Orlando and the unavailability of the meeting room.
Motion to adjourn at 8:00pm was made by Carolyn Kuenning. Motion was seconded by Carol Lustfeldt. Motion passed unanimously.
Respectfully Submitted
Cindy Hunziker, CPC
Secretary, Grand Canyon Coders
Local Chapter, Phoenix, AZ