The 2020 edition of the National Correct Coding Initiative (NCCI) Policy Manual features new guidance and clinical examples to help coders appropriately apply the -X{EPSU} modifiers debuted by CMS several years ago.
Modifier -25 can cause frustration as it is not recognized by many payers, including Medicaid. When applying this modifier, coders must consider CPT reporting rules and adhere to potentially restrictive billing rules followed by payers. Note : To access this free article, make sure you first register here if you do not have a paid subscription.
Sarah Nehring, CCS, CCDS , writes that CDI and coding professionals must understand the guidelines for coding myocardial infarctions (MI) as well as the clinical difference between type 1 MIs and type 2 MIs so they can be clinically validated, queried, and reported effectively to avoid negative reimbursement ramifications. Note : To access this free article, make sure you first register here if you do not have a paid subscription.
Julian Everett, RN, BSN, CDIP , reviews the background of the Program for Evaluating Payment Patterns Electronic Report (PEPPER) and says that even though the report is only made available through quality or chief financial departments, it is imperative CDI and coding staff have a seat at the table when discussing areas for improvement at a facility.
With the increased focus on clinical validation denials, more and more CDI professionals are finding themselves involved in the appeals-writing process and may initially feel a bit overwhelmed by the magnitude of the job. This article will provide you with best practices and appeal advice for those on the frontlines.
Ninety percent of hospital and inpatient organization leaders are considering outsourcing both clinical and non-clinical functions to achieve cost-efficiencies and succeed in value-based care models, according to a recent Black Book survey.
Q: Our coding department was told there were changes made for fiscal year (FY) 2020 when it comes to reporting healed/healing pressure ulcers and pressure-induced deep tissue damage. Can you explain any recent updates?
If you aren’t yet confused by the site-neutral payment policy changes prompted by CMS apparently ignoring both Congressional intent and the American Hospital Association (AHA) and other impacted hospitals filing suit, you are likely to become so now.
The 2020 update to the CPT Manua l includes extensive updates to cardiovascular codes, including new codes for pericardiocentesis and pericardial drainage, aortic grafting, and endovascular repair procedures.
