Outsourced coding audits for ICD-10-CM and ICD-10-PCS code sets are a common practice in inpatient facilities, and from national healthcare systems to physician practices, outside coding experts are engaged to audit coding accuracy, quality, and performance.
In recent years, numerous pieces of legislation have been passed to limit healthcare spending, combat losses due to fraud, and ensure that dollars are being spent on quality care. Adrienne Commeree, CPC, CPMA, CCS, CEMC, CPIP , describes different watchdog programs created to promote billing compliance and quality of care.
CPT modifier -22 for an increased procedural service is frequently reported incorrectly. Lori-Lynne A. Webb, CPC, CCS-P, CCP, CHDA, COBGC , describes the circumstances under which it would be appropriate to report modifier -22, and provides tips for accurate documentation to support use of the modifier.
CMS released Transmittal 3950 on January 12 describing updates to a list of the HCPCS codes for Durable Medical Equipment Medicare Administrative Contractors and Part B Medicare Administrative Contractor jurisdictions.
Drug abuse is a serious public health issue that affects millions of Americans. Familiarize yourself with diagnosis reporting for substance use disorders to ensure that ICD-10-CM-dependent administrative data accurately captures the social consequences of substance abuse. Note : To access this free article, make sure you first register here if you do not have a paid subscription.
Q: Our facility has attempted to use the -X{EPSU} modifiers on 2017 and 2018 claims but our Fiscal Intermediary Standard System (FISS) did not process the claims. I reverted to using modifier -59 (distinct procedural service). Do you have any knowledge of when these modifiers might go into use?
In November 2017, HCPro asked healthcare professionals about ICD-10 coding productivity. Based on respondent feedback, respondents were asked to report productivity based on records per hour or records per day. In previous years, respondents were asked to report productivity based only on records per hour.
James S. Kennedy, MD, CCS, CDIP, CCDS, reviews some ICD fundamentals and to help facilities develop a strategy that will ease the transition to the new administrative language as the federal government moves toward deployment of the International Classification of Diseases, 11th Edition, for Mortality and Morbidity Statistics (ICD-11-MMS).
Creating a query and knowing when to query can be complicated, and there are a number of training tactics that can prove successful for coders when trying to improve upon physician query practices. For this article, let’s take a look at when coders should query and when it’s appropriate for them to cite clinical evidence. Note : To access this free article, make sure you first register here if you do not have a paid subscription.
Q: We keep receiving denials for our use of ICD-10-CM code G94 (other disorders of brain in diseases classified elsewhere). Is there any coding guidance out there that can help our coding team decipher when we can use this code?
