General Surgery
General Surgery Billing and Coding Services Powered by AI
Master general surgery billing and coding accuracy with AI agents specialized in procedure-specific CPT/ICD codes, laparoscopic/robotic guidelines, facility vs ASC rules, and complex surgical workflows.
What Is General Surgery Billing and Coding?
General surgery billing and coding involves turning abdominal, endocrine, and soft tissue encounters (hernias, appendectomies, cholecystectomies, biopsies, and laparoscopies) into clean, payable claims.
Coders assign precise ICD-10-CM codes with laterality and episode details (e.g., K35.80 acute appendicitis), select appropriate CPT codes for open/laparoscopic/robotic procedures (e.g., 47562 lap chole), and apply modifiers per NCCI edits, global periods, and payer rules.
Billers verify coverage and prior authorizations for high-risk surgeries, scrub claims for medical necessity, and submit while tracking 90-day globals and complications.
90-Day Global Period Complexity
General surgery procedures trigger 90-day globals covering pre-op, surgery, and post-op care, requiring -24 (unrelated E/M), -58 (staged), and -78 (complications) modifiers for additional billing.
Impact: Underpayments when post-op visits incorrectly bundled
Laparoscopic vs Open/Conversion Coding
CPT codes differ dramatically (47562 lap chole vs 47600 open), with conversions requiring highest-value code plus modifier -22 for complexity documentation.
Impact: Downcoding and denials without operative approach specificity
Cancer Resection and Lymph Node Staging
Oncology surgeries demand precise lymph node counts (e.g., 38792 >10 nodes), margins, and sentinel node codes with pathology correlation for medical necessity.
Impact: Payer scrutiny and audits for unbundled staging procedures
Our Expertise in General Surgery Billing and Coding
Amy: AI Medical Coding Agent for General Surgery Care
- Codes surgical encounters with precise CPT, ICD-10, and modifier combinations for appendectomies, cholecystectomies, hernias, and cancer resections
- Applies global period rules (-24, -58, -78), laparoscopic/open conversions, and lymph node staging guidelines
- Flags missing approach details, margins, lymph node counts, and complication documentation
- Audits charts for high-volume errors like 90-day global bundling and NCCI edits
- Provides line-by-line rationale for every code ensuring audit transparency
Mark: AI Medical Billing Agent for General Surgery Care
- Verifies eligibility across Medicare, Medicaid, and commercial payers for elective and emergent surgeries
- Validates general surgery codes, global modifiers, and medical necessity before submission
- Submits claims and handles charge entry directly in your EHR/billing system
- Reads ERAs and scans paper EOBs to post payments and identify underpayments
- Continuously learns from surgery-specific denial patterns like CO-97 globals to prevent rejections
Adam: AI Denial Management Agent for General Surgery Care
- Checks claim status in real-time across payers for high-value procedures like lap conversions and cancer staging
- Makes AI-driven calls navigating IVRs and agents for global period disputes and PA appeals
- Uses customizable scripts for bariatric approvals, hernia mesh authorizations, and post-op complications
- Manages outbound/inbound calls with full call tracking
- Provides recordings, summaries, and recommendations to resolve aging surgical claims faster
What are the common documentation errors that trigger denials in surgery billing?
What are the key CPT codes commonly used in general surgery?
How do global periods apply to common general surgery codes?
Which CPT modifiers are most used in general surgery billing?
How is AI used in general surgery coding and billing?
Which is the best AI platform for general surgery coding and billing?
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