Q: If a patient comes into an outpatient facility for a surgical procedure and the physician evaluates the patient before performing the procedure, can you append modifier -25 to the E/M service?
A recent report from the Office of Inspector General focuses on improper payments for specimen validity tests billed in combination with urine drug tests. Yvette DeVay, MHA, CPC, CPMA, CIC, CPC-I, reviews Medicare instructions and coding guidance for presumptive and definitive drug testing.
Pelvic congestion syndrome is a chronic medical condition affecting millions of women between the ages of 20 and 45. Lori-Lynne Webb CPC, CCS-P, CCP, CHDA, COBGC, ICD-10-CM/PCS , reviews symptoms of the condition and reporting using CPT and ICD-10-CM codes.
Coders are on the front lines of claim submission and in a good position to foster compliance. Learn strategies to prevent fraud and abuse and encourage accurate documentation and billing within your outpatient facility. Note : To access this free article, make sure you first register here if you do not have a paid subscription.
Allen Frady, RN-BSN, CCDS, CCS, CRC, reviews various guidance related to clinical validation to help coders and CDI teams better navigate the complex topic.
A common question that coders often ask is when to report a secondary diagnosis. In part one of this two-part series, Gloryanne Bryant, RHIA, CDIP, CCS, CCDS , looks at the general coding guidelines related to secondary diagnosis coding found in the 2018 ICD-10-CM Official Guidelines for Coding and Reporting.
Shannon McCall, RHIA, CCS, CCS-P, CPC, CEMC, CRD, CCDS, writes that while the fiscal year (FY) 2019 IPPS proposed rule is considering the downgrade of ICD-10-CM code B20 (human immunodeficiency virus [HIV] disease) from an MCC to a CC, it does not mean that diagnosing and coding for HIV has lessened in complexity.
The fiscal year (FY) 2019 IPPS proposed rule includes updates to payment rates and quality initiatives, but some of the most extensive changes pertain to MCC and CC additions and deletions.
