In an effort to accommodate the latest advances in technology and make the code set easier to modify for future technological changes, the AMA extensively overhauled codes for reporting drug testing in the 2015 CPT ® Manual.
Do EHRs enable fraud and abuse by encouraging upcoding? What other factors could have led to higher levels of E/M coding over the past decade? Who or what organizations are responsible for ensuring compliance?
Most coding professionals have heard modifier -59 (distinct procedural service) referred to as a modifier of last resort and to be cautious in using this modifier.
Charging for inpatient ancillary procedures and supplies has always been confusing. "CMS provides very little guidance ... Its theory is that it's up to the provider to figure it out," says Kimberly Anderwood Hoy, JC, CPC, director of Medicare and compliance at HCPro, Inc., in Danvers, Mass.
Lately I've received a lot of questions from hospitals about how to determine when and if it's appropriate to report an E/M visit code on the same date of service as a scheduled procedure.
While the 2014 CPT ® Manual features many new combination codes among its hundreds of changes this year, it was also updated to reflect newly recognized technologies and procedures . Denise Williams, RN, CPC-H, looks atsome of the changes made in the Radiology and Laboratory sections.
Upon quick glance, codes for insertion, removal, and revision of pacemakers look quite different in ICD-10-PCS. The good news is that much of the logic that coders use to assign these codes in ICD-9-CM won't change. The silver lining? The procedure itself doesn't change, nor does anatomy.
The added specificity of ICD-10 may require coders to learn more about disease processes and terminology in order to code accurately. Lori-Lynne A. Webb, CPC, CCS-P, CCP, CHDA, COBGC, reviews some medical terms coders should know and steps to take to improve communication between providers and coders.
When coding guidelines are murky and open for interpretation, coders can sometimes feel as though they're pinned between a rock and a hard place. Discussing the gray areas of coding during a coding roundtable not only helps relieve this tension, but it also helps to establish policies that ensure consistency and continuity.
