Modifier -25 is frequently a target of payer and Office of Inspector General audits. Susan E. Garrison, CHCA, CPC, CPC-H, reviews CMS and NCCI guidance for reporting modifier -25.
Before radiation therapy can be administered, several steps must be taken prepare the patient for treatment. Review CPT coding and documentation for the first two steps in the process: the initial consultation and preparation for radiation treatment. Note : To access this free article, make sure you first register here if you do not have a paid subscription.
Medicare guidelines for reporting arthroscopic shoulder surgeries have changed significantly over the past decade. Review updated guidance and CPT coding for SLAP repairs as well as biceps tenotomy and tenodesis procedures to reduce audit risk. Note : To access this free article, make sure you first register here if you do not have a paid subscription.
Coding leadership can assist the chargemaster team by providing input, preparing appeals, and tracking coding-related denials. Rose T. Dunn, MBA, RHIA, CPA/CGMA, FACHE, FHFMA, CHPS , describes how to effectively work with a team of coders to combat continued denials.
Peggy S. Blue, MPH, CPC, CCS-P, CEMC , reviews the key characteristics of physician visits administered to patients in skilled nursing facilities and E/M coding for these services.
According to the American Academy of Orthopedic Surgeons, in 2013, 2 million people in the U.S. saw a physician for a rotator cuff problem. Review shoulder anatomy and CPT coding for rotator cuff repairs to improve coding accuracy. Note : To access this free article, make sure you first register here if you do not have a paid subscription.
Age-related macular degeneration (AMD) is a leading cause of vision loss among people age 50 and older, according to the National Eye Institute. Debbie Jones, CPC, CCA , reviews ICD-10-CM coding for AMD and CPT coding for treatments used to slow the disease’s progression.
A nine-month audit conducted by a CDI specialist at a family practice and internal medicine clinic revealed 1,353 coding errors on physician-coded claims for outpatient office visits. Tammy Trombley, RHIT, CDIP, CCDS , reviews findings from this 2017 audit and discusses implications for risk-adjustment coding.
Continuing with numerous requests for comment in last year’s OPPS proposed rule, CMS is once again asking stakeholders for feedback on a variety of issues for potential future rulemaking. Review OPPS proposals for quality measure changes and policies aimed at improving interoperability and the electronic exchange of information between providers.
In 2017, the U.S. Department of Health and Human Services (HHS) declared a nationwide public health emergency to address the opioid crisis, investing almost $900 million in opioid-specific funding to support treatment and recovery services. Learn about the epidemic and review ICD-10-CM coding and guidelines for reporting opioid use, abuse, dependence, and overdoses.
E/M code assignment for hospital admissions based solely on the provider’s documentation of face-to-face-time spent with a patient can be confusing and requires a detailed understanding of CPT guidelines. Lori-Lynne A. Webb , CPC, CCS-P, CCP, CHDA, COBGC , reviews reporting requirements for E/M visit levels based on the provider’s documentation of time and CPT coding for hospital admissions.
The 2019 Medicare Physician Fee Schedule (MPFS) proposed rule includes significant potential updates to E/M coding and reporting. Shannon McCall, RHIA, CCS, CCS-P, CPC, CEMC, CRC, CCDS , reviews the proposed changes and their potential impact on coding and billing for office visits and other outpatient services in 2019.
A common error and audit finding affecting providers is the lack of a physician order or physician signatures on medical documentation. Kimberly A. H. Baker, JD, CPC , reviews CMS guidance for physician signatures on medical documentation.
ICD-10-CM and CPT coding for glaucoma and retinal detachment requires a detailed understanding of coding guidelines as well as ocular anatomy and terminology. Explore the anatomy of the eye and review coding guidance for conditions that affect our view of the outside world. Note : To access this article, you must first register here if you do not have a paid subscription.
This second article in a series reviews common procedures used to isolate back pain and reduce inflammation including nerve block injections, facet joint injections, and facet denervation. CPT coding for these procedures is complex and requires a detailed understanding of spinal anatomy and terminology as well as coding guidelines. Note : To access this article, you must first register here if you do not have a paid subscription.
To succeed in a modern health information management (HIM) environment, coding departments need efficient coding specialists and knowledgeable management to monitor coder performance and provide feedback. Review expert guidance on hiring staff and determining work flow to improve the organizational structure of your coding department.
Hypertension, or high blood pressure, is not easily diagnosed and brings added risk factors to pregnancy oversight. Lori-Lynne Webb, CPC, CCS-P, CCP, CHDA, CDIP, COBGC, reviews ICD-10-CM coding for hypertension during pregnancy and related complications.
Coding professionals will need to familiarize themselves with 2019 updates to the ICD-10-CM Manual , including significant changes to chapter two for neoplasms and chapter 5 for mental disorders. Shannon McCall, RHIA, CCS, CCS-P, CPC, CEMC, CRC, CCDS , summarizes important 2019 ICD-10-CM updates , which will impact payment for claims submitted on or after October 1.
Provider documentation must meet required standards to support the level of care provided. Rose Dunn, MBA, RHIA, CPA/CGMA, FACHE, FHFMA, CHPS , reviews payer guidelines and medical necessity requirements under Medicare for services performed in the outpatient setting.
