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Evernote link: CPT Codes, or see below.
Major Organ Trauma, No Operation Required (MOTNOR) - The CPT code for recording non-operative trauma is 99199.
Guidelines include:
- The category “major organ trauma, no operation required” is defined as patients with major organ trauma who were admitted to a specialty care unit in the hospital, i.e., SICU, CCU, Burn Unit, etc.
- The most senior resident on the trauma service should claim credit for the MOTNOR case. In the instance where there is no trauma service, a fourth- or fifth-year general surgery resident may claim credit.
- If the patient subsequently requires a general surgery operative procedure that may be claimed in the defined category.
Surgical critical care patients - The CPT code for recording critical care patients is 99292
The Critical Care Index Cases (CCIC) log will document management of a broad scope of critical care patients as follows:
1. Each resident willd evelop a log of at least 20 critical care patients (actually number will be 40 next year) who best represent the broad scope of critical care index management.
2. Each of the patients listed on the log should include management of at least 2 of the 7 categories listed below.
3. The completed logs should include experience with at least one patient in all 7 of the following essential categories:
1. Ventilator management, 2. Bleeding (non-trauma) greater than 3 units necessitating transfusion and monitoring in ICU settings, 3. Hemodynamic instability, 4. Organ dysfunction/Failure (etiology/mode of management), 5. Dysrhythmias, 6. Invasive line management and monitoring, 7. Nutrition
Residents can identify the required minimum 20 (now 40) surgical critical care index cases by using CPT code 99292. Code 99292 will map to all 7 of the surgical critical care conditions. CPT code 99292 is different from the other codes. CPT Code 99292 (and it alone) will allow credit to be taken for multiple procedures on the same patient on the same day.
RRC Code Assignement to Surgical Critical Care Procedures
8410 - Ventilatory management (>24 hours on ventilator)
8420 - Bleeding (non-trauma patient > 3 units)
8430 - Hemodynamic instability (Req. ionotropic/pressor support)
8440 - Organ dysfunction (renal, hepatic, cardiac failure)
8450 - Dysrhythmias (requiring drug management)
8460 - invasive line management/monitoring (Swan-Ganz, catheter, a-lines, etc.)
8470 - Parenteral/enteral nutrition
Appendix
+44955 Appy w Other Procedure
44950 Appendectomy
44960 Appy for rupture/abscess
44970 Lap Appy
Gallbladder
47600 Cholecystectomy
47605 Chole w IOC
47610 Chole w CBDE
47562 Lap Chole
47563 Lap Chole w IOC
47564 Lap Chole w CBDE
47550 Intraop Choledochoscopy
74300-26 Cholangiography
Open Hernia
49505 Inguinal
49507 Inguinal Incarcerated
49520 Inguinal Recurrent
49521 Inguinal Recurrent Incarc'd
49550 Femoral
49553 Femoral Incarcerated
49585 Umbilical
49587 Umbilical Incarcerated
49570 Epigastric
49572 Epigastric Incarcerated
49560 Ventral
49561 Ventral Incarcerated
49565 Ventral Recurrent
49566 Ventral Recurrent Incarc'd
15734 Myocutaneous Flap
49568 Mesh Implantation
+11008 Removal Infected Mesh Abd
Laparoscopic Hernia
49652 Lap Vent/Umb/Epi
49653 Lap Vent/Umb/Epi Incarc'd
49654 Lap Incisional
49655 Lap Incisional Incarc'd
49656 Lap Vent/Incis Recurrent
49657 Lap Vent/Incis Rec Incar'd
49650 Lap Inguinal
49651 Lap Inguinal Recurrent
Breast
19100 Core Needle Bx
19120 Excisional Bx
76642 US Breast w Image Doc
19125 Exc Bx w Wire Localization
38525-51 SLN Bx Axilla
38900 Inj Dye for SLN Bx
76098-26 Specimen X-Ray
19301 Partial Mastectomy
19302 Partial Mast w ALND
19303 Mastectomy Simple
19307 Mastectomy Mod Rad
19300 Mastectomy Gynecomastia
19081 Stereo Bx, X-ray, + Clip
19297 CED in OR w Lumpectomy
Abdomen
49000 Ex Laparotomy + Bx
49320 Ex Laparoscopy
49321 Ex Laparoscopy w Bx
49421 Open PD Cath
49422 Removal PD Cath
49324 Lap PD Cath
49325 Lap Revision PD Cath
49002 Reopening Recent Lap
60540 Adrenalectomy
60650 Laparoscopic Adrenal
Esophagus
43107 Transhiatal Esophagectomy
43279 Lap Heller
43330 Open Heller
43280 Lap Nissen
43327 Open Nissen
43281 Lap Paraesoph Hernia
43282 Lap Paraesoph w Mesh
43332 Open Paraesoph Hernia
43333 Open Paraesoph w Mesh
Stomach
43610 Exc Benign Tumor
43611 Exc Malignant Tumor
43631 Partial w Bilroth I
43632 Partial w Bilroth II
43633 Partial w RNY
43800 Pyloroplasty
43830 Open Stamm G-tube
43246-62 PEG Tube
43501 Suture Bleeding Ulcer
43840 Suture Perforated Ulcer
Intestinal
44005 Enterolysis
44180 Lap Enterolysis
44120 Enterectomy Single
44300 Feeding J-tube Tube
44186 Lap Feeding J-tube
+44015 J-tube w Other Proc
44050 Reduct Volvulus/Int Hernia
44160 Ileocolectomy w Anast
44205 Lap Ileocolectomy w Anast
Colon
44320 Colostomy
+44139 Mobilization Splenic Flex
+44213 Lap Mobil Splenic Flex
44140 Part Colect w Anast
44145 Part Colect w Pelvic Anast
44143 Part Colect w Hartmann's
44150 TAC w End Ileostomy
44204 Lap Part Colect w Anast
44207 Lap Part Col w Pelvic Anast
44626 Hartmann's Takedown
44625 Ileostomy Takedown
45300 Rigid Proctoscopy
Liver
47100 Wedge Bx
+47001 Liver Bx w other Proc
47120 Partial Lobectomy
47125 Total Left
47130 Total Right
47300 Marsup Cyst/abscess
47380 RFA
47370 Lap RFA
Spleen
38100 Total Splenectomy
38120 Lap Splenectomy
Pancreas
48140 Distal Panc + Spleen
48150 Whipple w Panc-J
48152 Whipple w/o Panc-J
Bariatric
43846 Open RNY Bypass
43644 Lap RNY Bypass
43770 Lap Band
43774 Removal Lap Band
43775 Lap Sleeve (43659)
Vascular Access
36561 Hick/Gros Port Placement
36590 Hick/Gros Port Removal
77001-26 Fluoroscopy
76937-26 US Vascular Access
Lymph Nodes
38500 Superficial, any
38510 Deep Cervical
38525 Deep Axillary
38570 Laparoscopic RP LN Bx
Neck
31600 Trach Planned
60220 Thyroid Lobectomy
60240 Total Thyroidectomy
60500 Parathyroidectomy
+60512 PTH autotransplant
Other Procedures
62223-62 Create VP Shunt Brain
62230-62 Revis/ replce CSF Shunt
32551 Chest Tube
22558-62 Lumbar Arthorodes
10060 I&D Simple
10061 I&D Complex or Multiple
10140 I&D Hematoma/Seroma
11771 Exc Pilonidal Extensive
11450 Hidradenitis, Axillary
97605 VAC up to 50 cm sq
97606 VAC over 50 cm sq
Modifiers
-22Increased Procedural Services
-24Unrelated E/M during same post op
-25E/M same day as Minor procedure
-57E/M same day as Major procedure
-78Unplanned return to OR, related
-79Unplanned return to OR, unrelated
-82Assistant Surgeon, no resident available
Encounters *** No Medicare Patients ***
Consults INPATIENT
99251Minimal
99252Expanded
99253Detailed
99254Moderate
99255Hi Complexity
Consults OBSERVATION
99241Minimal
99242Expanded
99243Detailed
99244Moderate
99245Hi Complexity
Initial INPATIENT
99221Low/ Brief
99222Moderate
99223Complex
Subsequent INPATIENT
99231Brief Care
99232Limited
99233Comprehensive ICU
99238D/C Day < 30 min
99239D/C Day > 30 min
Initial OBSERVATION
99218Low/ Brief
99219Moderate
99220Hi Complex
Subsequent OBSERVATION
99224Low/ Brief
99225Moderate
99226Hi Complex
99217OBS Discharge
EMERGENCY ROOM Visit
99281Minor
99282Low/ Expanded
99283Detailed
99284Moderate
99285Hi Complexity
CRITICAL CARE
9929130 - 74 minutes
+99292additional 30 minutes
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