In the outpatient world, physicians are accustomed to seeing services as the key to reimbursement, but diagnoses and outcomes will increasingly factor into reimbursement as healthcare shifts toward value-based care. Note: To access this free article, make sure you first register here if you do not have a paid subscription.
Coding and billing for the transgender patient can be difficult even when society in general has become more aware of people who are transgender. Lori-Lynne A. Webb, CPC, CCS-P, CCP, CHDA, COBGC, covers some of the challenges coders may face when filing claims for transgender patients.
James S. Kennedy, MD, CCS, CDIP , discusses the new ICD-10-CM codes for FY 2018 and describes some of the changes that could be made to documentation and billing habits for these conditions.
The 2018 OPPS proposed rule included potential changes to certain radiology modifiers used by CMS to identify services for data collection as well as reimbursement.
Q: What are the applicable modifiers that can be used when a test fails for medical necessity or if an Advance Beneficiary Notice (ABN) has been signed?
