Planning a big bonfire for October 1, 2014, using your ICD-9-CM Manuals? You might want to think again. Not everyone is required to transition to ICD-10. Only HIPAA covered entities must begin using...
Q: A surgeon’s dictated report for a right hip hemiarthroplasty states the following: Of note, while drilling one of our transosseous suture holes with a 2.0 mm drill bit, the end of the drill bit broke off inside of the trochanter. It seemed to be quite deep into the bone and was not retrievable. As such, it was left in place. Should we report 998.4 (foreign body accidentally left during a procedure) for this case?
Although coders and billers don’t play a role in determining whether condition code 44 is appropriate, they certainly ensure correct billing of the code. Deborah K. Hale, CCS, CCDS, and John Zelem, MD, FACS, review the requirements for condition code 44 and when coders should report it.
Under a new ruling, CMS allows full Part B payment for inpatient stays that a contractor denies because it deems them to be not reasonable and necessary. David Danek and Ann Marshall, both from CMS, explain how the rebilling works under the ruling and what will be different under a simultaneously released proposed rule.
The increasing complexity of the healthcare reimbursement system, quality initiatives, and the transition to ICD-10-CM/PCS put clinical documentation improvement programs in the spotlight . Melanie Endicott, MBA/HCM, RHIA, CDIP, CCS, CCS-P, FAHIMA, discusses the importance of documentation improvement specialists.
I love the ICD-10-CM external causes codes. I’m weird, I know, but I’m also a writer and I love telling good stories. When I first started coding, my boot camp instructor Peggy Blue, MPH, CPC, CCS-P...
Penny comes in to see Dr. Morang for pain in her wrist. After performing a comprehensive exam and history, Dr. Morang documents the following ICD-9-CM codes: 354.0, carpal tunnel 715.04,...
In this month's issue, we examine CMS' Part A to Part B rebilling ruling and proposed rule, look at how facilities are being reimbursement for the new molecular pathology codes, review changes to the I/OCE for April, and answer your questions.
The AMA revised the molecular pathology codes in the CPT ® Manual in 2012, but at that time CMS did not adopt the codes as it was still debating whether and how to change the reimbursement system for these services going forward. For CY 2013, CMS elected to recognize the codes, which meant it had to finalize how to pay for them. While CMS did not change pamyent for these services under the Clinical Laboratory Fee Schedule (CLFS) despite industry pressure, its change to the new codes means a change in the payments providers can expect this year and in the future.
In February, AHIMA published an update to its 2010 query practice brief. The updated brief, Guidelines for Achieving a Compliant Query Practice, is the result of a joint effort between AHIMA and the Association for Clinical Documentation Improvement Specialists (ACDIS). ?
Anesthesia coding in some ways is similar to evaluation and management coding—only easier. Chandra Stephenson, CPC, CPC-H, CPMA, CPC-I, CANPC, CEMC, CFPC, CGSC, CIMC, COSC, explained the 10 steps to coding anesthesia during the AAPC National Conference in Orlando, Fla., April 14-17.
Don't let underpayments fly under the radar Nearly 75% of participating hospitals nationwide with RA activity reported receiving at least one underpayment determination, according to the AHA...
CMS corrected edit 84, added five APCs to the I/OCE, deleted two APCs, and changed the description of another as part of the April updates to the I/OCE. In addition, CMS deleted all of the genetic testing modifiers, retroactive to January 1.
The April 2013 issue of CMS’ Medicare Quarterly Provider Compliance Newsletter highlights two Comprehensive Error Rate Testing (CERT) issues that affect outpatient providers.
CMS corrected edit 84, added five APCs, deleted two APCs, and changed the description of another as part of the April updates to the I/OCE. Dave Fee, MBA, reviews the most significant changes CMS implemented
Gloria Miller, CPC, vice president of reimbursement services for Comprehensive Healthcare Solutions, Inc., located in Tacoma, Wash, created this quick reference for HCPCS Level 1 modifiers commonly used in wound care coding.
Coders should question the validity of coding advice and work collaboratively with physicians to develop sound coding guidelines. Last month, I addressed coding advice related to percutaneous endoscopic gastrojejunostomy and cardiorenal syndrome. This month, I’ll address coding advice related to several other conditions.
The three-day payment window has been wrought with compliance challenges since its inception. In January, CMS updated the policy to provide additional clarification.
Our experts answer questions about modifiers for diagnostic interventional procedures, Medicare recognition of CPT ® code 9066, reporting add-on code for psychotherapy with interactive complexity, reporting G0378 for all payers, and wound care coding.
