Print Friendly Print     Email this page Email    

Precourse 02: 2013 Coding and Reimbursement for Hand Surgeons

​Wednesday, October 2, 2013

7:30 – 11:30 AM

Moscone West 2020 


Co-Chairs: Mary S. LeGrand, RN; Daniel J. Nagle, MD

Precourse Fees:

ASSH Member - $195
ASSH Senior Member - $145
Non-Member Surgeon - $225
Allied Health - $125
Resident/Fellow - $75
Includes printed syllabus.


A precourse survey identified 3 main topics of interest for this year’s coding course.  These topics included E&M coding and documentation, how to avoid audits and modifiers.  Running closely behind these 3 main topics were interests in fracture coding and hand trauma.  Based on popular demand, the course will address risk areas associated with EMR/EHR implementation, E&M utilization patterns, what payors are looking for and “What is in The News!”  We will provide an overview of E&M coding and documentation focusing on E&M categories, documentation requirements for the key components (history, exam and medical decision making) and how to “pull it all together” in reporting E&M services.  This course will also focus on coding rules related to the use of modifiers and hands-on skills application focused on common hand surgery cases, fracture coding and hand trauma.  As part of this year’s course we will introduce hand surgeons to some of the documentation changes required for ICD 10 and recommendations to conduct a gap analysis to further identify documentation gaps and opportunities.  This course, presented by the only nationally recognized hand surgery coding specialist in collaboration with a hand surgeon, is intended for hand surgeons, billing managers and coding and billing staff. 

Learning Objectives:

At the conclusion of the program, participants will be able to:
  • Identify potential risk areas in EMR implementation and steps to fall into the traps.
  • Understand key documentation requirements for selecting and reporting E&M services.
  • Apply surgical and E&M modifiers when reporting office-related services and surgical procedures.
  • Describe coding and reimbursement rules according to CPT Coding rules and Medicare reimbursement rule.
  • Accurately report fracture management services.
Audience Level: Intermediate through advanced
Keyword(s): Coding, Reimbursement, Risk, Audit, Modifiers, Global Surgical Package, Medicare, CPT
Category: Practice management 
CME: The ASSH designates this live activity for a maximum of 4.00 AMA PRA Category 1 Credits™.  Physicians should claim only the credit commensurate with the extent of their participation in the activity.
The ASSH is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians.


Mary LeGrand, RN, MA, CCS-P, CPC - KarenZupko & Associates, Inc.
Daniel J. Nagle, MD
View faculty financial relationship disclosures here


Daniel J. Nagle, MD
E&M Documentation
Mary LeGrand, RN, MA, CCS-P, CPC
  • Where Is Your Risk and How Do You Know?
  • Documentation for Levels of Services (History, Exam and Medical Decision Making)
  • E&M Code Selection: Categories and Key Components
  • Time as a Contributing Component
Surgical Package Definition Review
Mary LeGrand, RN, MA, CCS-P, CPC
  • CPT
  • Global Service Data  for Hand Surgeons/ AAOS Global Service Date Guide
  • Medicare
Modifiers: CPT vs Medicare
Mary LeGrand, RN, MA, CCS-P, CPC
  • Modifiers 25, and 57
  • Modifiers 50, 51 and 59
  • Injections
    • Joints/ Tendons/PRP
    • Ultrasound
      • Diagnostic
      • Ultrasound Guided Injections
    • Radiology Requirements
  • Modifiers 58,78, and 79
  • Modifiers 80,81, 82 and AS
Fracture /Trauma Update 2013
Mary LeGrand, RN, MA, CCS-P, CPC
  • Fracture Billing: What’s Included, What’s Not?
  • Debridement Documentation
  • Fixation: Hardware Removal, External Fixation
  • Use of Operating Microscope
  • Case Examples
Hand Specific Case Examples
Mary LeGrand, RN, MA, CCS-P, CPC


Introduction to ICD-10

  • Documentation Changes
  • Gap Analysis
Coding Resources/References
  • Code-It for Hand Surgery (ICD-9-CM cheat sheet)
  • Global Service Data for Hand Surgery eBook Edition
  • AAOS Global Service  Data Guide
Closing Remarks

© 2014  American Society for Surgery of the Hand | Contact Us  |  Future Meetings  |  Meeting Archives  |  Privacy Policy | Disclaimer