Q: If a patient is seen for a pressure ulcer on the foot related to diabetes, would you report a diabetes diagnosis code? If surgical debridement is performed and the patient receives treatment for their diabetes, can you charge for both an office visit and debridement?
While oral arguments in the American Hospital Association’s (AHA) lawsuit against CMS for its cuts to 340B drug payments in the 2018 OPPS final rule don’t begin until May 4, providers may want to take steps now to preserve their appeal rights if the AHA’s lawsuit is successful.
Telehealth services continue to expand and claims for these services may already be under scrutiny by Medicare contractors. Debbie Mackaman, RHIA, CPCO, CCDS, writes about the differences between originating site and distant site services in addition to coding, billing, and reimbursement for telehealth services.
Coders and clinical documentation improvement specialists play a key role in the success of quality payment programs such as MIPS. This article describes the financial impact that hierarchical condition category coding has on provider reimbursement and the coder’s role in ensuring complete, accurate, and timely documentation. Note : To access this free article, make sure you first register here if you do not have a paid subscription.
It’s estimated that more than half a million people in the U.S. are diagnosed with Crohn’s disease. Debbie Jones, CPC, CCA , outlines symptoms and treatments for Crohn’s disease, as well as ICD-10-CM coding for the condition and associated complications.
CMS held a listening session March 21 to gather input from stakeholders on potential updates to the E/M documentation guidelines. The current guidelines are considered outdated in light of medical advances and the advent of the electronic health record.
Almost 70% of Americans are considered overweight or obese. Shannon E. McCall, RHIA, CCS, CCS-P, CPC, CPC-I, CEMC, CRC, CCDS , reviews ICD-10-CM coding and HCC risk adjustment for obesity.
Coding for hydration and chemotherapy administration can be a daunting task for both beginner and experienced coders, who may not understand the hierarchy rules and gray areas in the CPT guidelines. Review correct coding for these services and how they fit into the hierarchy. Note: To access this free article, make sure you first register here if you do not have a paid subscription.
In response to ongoing criticism from physicians and the government’s own advisory panel against the Medicare Access and CHIP Reauthorization Act (MACRA), the U.S. House Committee on Ways and Means Subcommittee on Health held a hearing Wednesday, March 21, to defend the administration’s implementation strategy for the new physician payment program.
