Plastic & Reconstructive Surgery Billing & Coding Services

Due to multiple procedure payment reduction rules, co-surgeries, varying levels of wound repair codes (simple/ intermediate/ complex),  and the need to use the right surgical and E/M modifier codes, plastic surgery medical coding can be confusing. Medical Coding errors cause delayed or denied reimbursements, leading to revenue loss and loss of time available for patient care. Plastic and reconstructive procedures are costly, and hence, the practices need to work hard and adhere to billing and coding guidelines. 

Medical Billing Wholesalers offers comprehensive plastic surgery coding services to reduce claim denials and bring you maximum reimbursement for all services.

Our Expertise in Medical Billing and Codingf or Plastic & Reconstructive Surgery

At MBW, we have a client base that extends across all 50 states, covers a wide range of hospitals, physician practices, and medical billing companies. Our team of billers & coders employ their experience and knowledge acquired through a decade of working with plastic surgeons in improving your revenue & accelerating growth. Our coders are proficient in CPRC, ICD-9/10, CPT, HCPCS coding guidelines provided by CMS and AMA, and certified by the American Academy of Professional Coders (AAPC). Our coding experts are:

• Experts in reading and understanding physician office notes and procedure note to apply correct ICD-10-CM, CPT®, HCPCS Level II, and modifier coding assignments

• Evaluation and management (both the 1995 and 1997 Documentation Guidelines)

• Possess adequate knowledge of the rules and regulations of Medicare billing, including (but not limited to) incident, teaching situations, shared visits, consultations, and global surgery

• Capable of accurately coding for surgical procedures performed by plastic and reconstructive specialists such as scar revisions, facial repairs, cosmetic surgeries, etc.

• Trained extensively on Medical terminologies & human anatomy and physiology

Applying best practices for Plastic and Reconstructive Surgery Billing and Coding

At MBW, we understand the challenges faced by Plastic and Reconstructive surgery providers. Rapidly changing policy rules, ICD updates, and your specialty's sensitive nature can make the billing and coding services complex. Our certified billers and coders are well-versed in the nuances of billing for plastic and reconstructive surgery procedures. We understand the differences between cosmetic and medically necessary plastic surgeries and the respective coding and reimbursement guidelines. We process your claims accurately, improve clean claims rate, and accelerate your cash flow.

We have built our approach by adhering stringently to coding guidelines & bests practices and applying modern technology. The MBW team focuses on providing data-driven solutions that help reduce denials and increase revenue.

Our best practices in plastic & reconstructive surgery include:

• Choosing appropriate ICD codes for neoplasm, breast-related issues, facial nerve disorders, different types of burns, and other disorders

• Applying correct CPT codes for procedures including but not limited to the following:

  • Breast reconstruction—extensive discussion including DIEP flaps

  • Skin lesion procedures including injection, biopsy, shave, and excision

  • Nasal procedures including rhinoplasty, nasal valve stenosis repair, and turbinates

  • Hand surgery

• Reporting Level 4 or Level 5 E/M services with appropriate codes and modifiers and correctly applying consultation code

• Adding appropriate modifiers for multiple procedures in a global period (51 and 59) co-surgeon (62) or assistant surgeon (80, 82) services to optimize your revenue

Our Value

We bring finesse and accuracy to our billing and coding services while building a flawless reimbursement process for your practice. With diligent patient demographics entry, insurance verification, insurance authorizations, coding, billing, and payments reconciliation can add value to your organization. We ensure consistent accounts receivable follow-up and prior authorization to avoid claim denials. Our denial team's #1 priority is shifting your focus from denial management to denial prevention. Our team strives to introduce a friction-free billing, coding, claim submission, and payment posting process.