One in 12 adults suffer from alcohol abuse or dependence, and more than half of adults have a family history of alcoholism or problem drinking. Adrienne Commeree, CPC, CPMA, CCS, CEMC, CPIP, outlines ICD-10-CM rules for substance use, abuse, and dependence, and diagnosis coding for alcohol-related conditions.
It’s estimated that more than half a million people in the U.S. are diagnosed with Crohn’s disease. Debbie Jones, CPC, CCA , outlines symptoms and treatments for Crohn’s disease, as well as ICD-10-CM coding for the condition and associated complications.
Coding for hydration and chemotherapy administration can be a daunting task for both beginner and experienced coders, who may not understand the hierarchy rules and gray areas in the CPT guidelines. Review correct coding for these services and how they fit into the hierarchy. Note: To access this free article, make sure you first register here if you do not have a paid subscription.
Even experienced coding professionals find injection and infusion coding confusing because CPT guidelines for these services differ from the guidelines for most other services. Review the drug administration hierarchy and guidelines for reporting therapeutic, prophylactic, and diagnostic injections and infusions. Note : To access this free article, make sure you first register here if you do not have a paid subscription.
Valerie Rinkle, MPA, writes about CMS’ hospital prohibition of unbundling rules and a new outpatient date of service exception for molecular pathology and advanced diagnostic laboratory tests.
Stress urinary incontinence is a common problem induced by minor physical stressors such as laughing, coughing, or sneezing. Lori-Lynne A. Webb, CPC, CCS-P, CCP, CHDA, COBGC , writes about CPT coding for procedures such as sling operations and laparoscopies, used to treat urinary stress incontinence.
Medical necessity documentation, or lack thereof, is one of the most common reasons for claim denials. This article describes how medical necessity impacts third-party payers and those who work in billing and reimbursement services.
Wound care coding can be challenging as wound size, depth, and severity must be properly documented to report the most accurate codes. Review coding for pressure ulcers in ICD-10-CM and wound debridement in CPT to avoid common documentation and reporting errors. Note : To access this free article, make sure you first register here if you do not have a paid subscription.
Shannon E. McCall, RHIA, CCS, CCS-P, CPC, CPC-I, CEMC, CRC, CCDS , writes about discussions at the AMA CPT Symposium that could impact coders, including the need for updates to CMS’ E/M Documentation Guidelines and how medical decision making is used as a key component for E/M reporting.
The skin is the largest organ in the human body and plays a vital role in protecting the body from injury and illness. This article reviews integumentary anatomy and provides guidance to aid in accurate ICD-10-CM and CPT code assignment for complex integumentary diagnoses and procedures. Note : To access this free article, make sure you first register here if you do not have a paid subscription.
Bundled Payments for Care Improvement Advanced, a new voluntary bundled payment model launched by CMS in January, includes 32 clinical episodes encompassing both inpatient admissions and outpatient procedures. Yvette DeVay, MHA, CPC, CPMA, CIC, CPC-I , writes about participation criteria, payment calculations, and quality measures for this program.
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.
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.
Approximately 2%-3% of children between the ages of 6 and 12, and 6%-8% of adolescents in the U.S. may have serious depression. Debbie Jones, CPC, CCA details common symptoms of anxiety and depression in adolescence and provides advice for diagnostic coding of these conditions.
Updates to the 2018 CPT Manual particularly effect coding for cardiovascular and laboratory procedures. Stay-up-to-date with these changes and take time to understand complex procedures to prevent interruptions to claims processing. Note : To access this free article, make sure you first register here if you do not have a paid subscription.
New ICD-10-CM/PCS codes provide additional specificity to describe the condition of and care afforded to a given patient. This article takes a closer look at these code updates as well as guidelines for reporting codes under new payment models.
In this article, Valerie A. Rinkle, MPA, offers guidance regarding the 340B drug discount program. She provides tips for accurate documentation of drug purchases and reviews frequently asked questions about billing for 340B-acquired drugs in 2018.
Coding for damage control surgery and acute blood loss anemia can be difficult when clear provider documentation is not found within the medical record. Lori-Lynne A. Webb, CPC, CCS-P, CCP, CHDA, COBGC, outlines best practices for identifying anemia and ensuring more accurate documentation.
Complying with healthcare regulations within a coding department or physician practice involves promoting a positive attitude toward activities such as self-monitoring and staying up-to-date with healthcare regulations. Follow these steps to adhere to sound business ethics and set expectations for behavior across an organization. Note: To access this free article, make sure you first register here if you do not have a paid subscription.
The improper payment rate for hospital outpatient services was 5.4%, accounting for 7.5% of the Medicare Fee-For-Service improper payment rate, according to 2016 Medicare Fee-for-Service Improper Payments Report.
