Procedure Coding in Family Medicine
As managed care organizations and government payers have focused on controlling medical costs, many family physicians have been “squeezed” by flat or declining revenue and increasing overhead. To maintain financial viability, family physicians and office managers must try to maximize revenue collected for the services they provide. Accurate coding of evaluation and
management (E/M) services, billing for all services rendered, aggressive follow-up on claim denials and delinquent accounts, and correct coding of procedures are key areas where revenue enhancement can occur. Most family physicians perform some procedures in the office in order to provide convenient, cost-effective care, maintain skill levels, and as a source of revenue. The most frequent procedures done in family practice offices, according to HCFA data, are as follows:
• Removal of Impacted Ear Wax (CPT 69210)
• Arthrocentesis, Major Joint (CPT 20610*)
• Hot/Cold Pack (CPT 97010)
• Destruction Lesion, Benign (CPT 17000*)
• Spirometry (CPT 94010)
• Flexible Sigmoidoscopy (CPT 45330)
• Biopsy, Skin (CPT 11100)
• Injection Tendon Sheath/Ligament/Cyst (CPT 20550*)
This article provides some basic guidelines for proper procedure coding.