Lori-Lynne A. Webb, CPC, CCS-P, CCP, CHDA, COBGC , unpacks ICD-10-CM coding for uncommon obstetric (OB) complications and symptoms and CPT coding for surgical management of miscarriages.
ICD-10-CM coding for neuropathies can be challenging given the complexity of these diagnoses and associated complications. Demystify documentation requirements and ICD-10-CM coding for ischemic and hemorrhagic strokes, migraine headaches, and paralysis. Note : To access this free article, make sure you first register here if you do not have a paid subscription.
Q: A wound care patient with a 25-sq-cm chronic foot ulcer presents with a new cellulitic rash, which is treated using topical medication. During the visit, the physician also surgically removes dead tissue from the ulcer. How would these services be reported in CPT?
The October 2021 quarterly update to the OPPS announces new HCPCS codes for endoscopic submucosal dissection and central venous catheterization. It also introduces new HCPCS drug codes and revisions to the list of those qualifying for pass-through payment status.
ICD-10-CM coding for neuropathies can be challenging given the complexity of these diagnoses and associated complications. Demystify documentation requirements and ICD-10-CM coding for ischemic and hemorrhagic strokes, migraine headaches, and paralysis.
Lori-Lynne A. Webb, CPC, CCS-P, CCP, CHDA, COBGC , breaks down CPT coding for diagnostic services performed during the second and third trimesters, and provides an overview of an obstetric (OB) hospitalist's role in caring for high-risk maternity patients.
Several CPT modifiers have similar definitions, which can make distinguishing between them challenging. Review guidance for the appropriate application of modifier -51 versus -59 and discontinued service modifiers -52, -53, -73, and -74.
Lori-Lynne A. Webb, CPC, CCS-P, CCP, CHDA, COBGC , breaks down CPT coding for diagnostic services performed during the second and third trimesters, and provides an overview of an obstetric (OB) hospitalist's role in caring for high-risk maternity patients.
Several CPT modifiers have similar definitions, which can make distinguishing between them challenging. Review guidance for the appropriate application of modifier -51 versus -59 and discontinued service modifiers -52, -53, -73, and -74. Note : To access this free article, make sure you first register here if you do not have a paid subscription.
Shelley C. Safian, PhD, RHIA, CCS-P, COC, CPC-I , writes about endocrine anatomy and physiology as well as ICD-10-CM/CPT coding for thyroid, parathyroid, adrenal, and pineal irregularities.
Q: The 2022 ICD-10-CM code set includes a new code, U09.9 (post-COVID-19 condition, unspecified), for post-COVID-19 conditions. When would it be appropriate to report this code? A: The fiscal year...
John Peter Smith Hospital in Tarrant County, Texas, has agreed to pay $3.3 million to settle allegations that it was in violation of the False Claims Act by upcoding certain claims.
Outpatient coding for injections and infusions can be challenging given the foundational definitions and complex rules that drive reporting of these services. This article breaks down the facility drug administration hierarchy and CPT coding for therapeutic infusions, injections, and hydration. Note : To access this free article, make sure you first register here if you do not have a paid subscription.
Lori-Lynne A. Webb, CPC, CCS-P, CCP, CHDA, COBGC , breaks down CPT coding for ancillary services provided by obstetric providers including targeted ultrasound services and maternal serum tests used to screen for fetal abnormalities.
Q: A 32-year-old female presents for a planned vaginal delivery of twins. Twin A is delivered vaginally but due to complications, the second-born is delivered via a caesarean section (C-section). How would these obstetric services be reported in CPT?
CMS overpaid physicians an estimated $1.7 million for transitional care management (TCM) services over a two-year period, according to a recent Office of Inspector General (OIG) report. Overpayments were due to CPT coding and billing errors.
CMS recently released the 2022 Medicare Physician Fee Schedule proposed rule, which introduces new guidelines for reporting split/shared visit services. Julia Kyles, CPC , analyzes how the changes would impact physician practices.
Outpatient coding for injections and infusions can be challenging given the foundational definitions and complex rules that drive reporting of these services. This article breaks down the facility drug administration hierarchy and CPT coding for therapeutic infusions, injections, and hydration.
To select the most specific CPT codes for prenatal care, physician coders must have a solid understanding of complex guidelines for reporting pregnancy-related office visits. Lori-Lynne A. Webb, CPC, CCS-P, CCP, CHDA, COBGC , unpacks services included in the global obstetric package and CPT coding for routine prenatal care.
Medicare overcompensated providers for complex and noncomplex chronic care management (CCM) services billed over a two-year period, according to a recent OIG report. These overpayments occurred because CMS did not have claim edits in place to prevent billing of overlapping care management services.
Earlier this year, the Office of Inspector General (OIG) added a new OIG Work Plan item for reporting E/M services with minor surgical procedures. Joe Rivet, Esq., CCS-P, CPC, CEMC, CPMA, CICA, CHRC, CHPC, CHEP, CHC, CICA, CAC, CACO , reviews appropriate use of modifier -25 for separately identifiable E/M services.
CPT coding for vaginal and cesarean deliveries and postpartum care requires strong attention to detail. Lori-Lynne A. Webb, CPC, CCS-P, CCP, CHDA, COBGC , breaks down stages of delivery and CPT coding guidance for childbirth.
Review proposed updates to the CPT set for 2022, including new codes for chronic care management, laser interstitial thermal therapy, spinal anesthesia, and more. Note: To access this free article, make sure you first register here if you do not have a paid subscription.
Hospital coders often review charts for patients with diarrhea, ulcerative colitis, and other colorectal problems. Review ICD-10-CM coding for common conditions of the large intestine and CPT coding for proctosigmoidoscopies, sigmoidoscopies, and colonoscopies. Note : To access this free article, make sure you first register here if you do not have a paid subscription.
To select the most specific CPT codes for prenatal care, physician coders must have a solid understanding of complex guidelines for reporting pregnancy-related office visits. Lori-Lynne A. Webb, CPC, CCS-P, CCP, CHDA, COBGC , unpacks services included in the global obstetric package and CPT coding for routine prenatal care.
The American Medical Association (AMA) recently announced that it updated the CPT code set to include new codes for third doses of the Moderna and Pfizer/BioNTech COVID-19 vaccines.
Read up on ICD-10-CM code updates for fiscal year 2022, including new codes for post-COVID-19 symptoms, social determinants of health, and poisonings by cannabis and synthetic cannabinoids.
Cardiovascular conditions affect the structure and function of the heart and are a leading cause of death in the U.S., according to the Centers for Disease Control and Prevention. This article details ICD-10-CM coding for common heart conditions and CPT coding for cardiac catheterization procedures.
The 2022 Medicare Physician Fee Schedule (MPFS) proposed rule includes significant policy updates affecting physician coding and billing. Review proposals to decrease to the Medicare conversion factor, revise guidelines for critical care services, and loosen telehealth coverage requirements.
Read up on ICD-10-CM code updates for fiscal year 2022, including new codes for post-COVID-19 symptoms, social determinants of health, and poisonings by cannabis and synthetic cannabinoids.
The 2022 Medicare Physician Fee Schedule (MPFS) proposed rule includes significant policy updates affecting physician coding and billing. Review proposals to decrease to the Medicare conversion factor, revise guidelines for critical care services, and loosen telehealth coverage requirements.
Debbie Jones, CPC, CCA , breaks down CPT coding for extracorporeal shock wave lithotripsy (ESWL)—a non-surgical treatment used to destroy kidney stones.
Cardiovascular conditions affect the structure and function of the heart and are a leading cause of death in the U.S., according to the Centers for Disease Control and Prevention. This article details ICD-10-CM coding for common heart conditions and CPT coding for cardiac catheterization procedures. Note : To access this free article, make sure you first register here if you do not have a paid subscription.
Staten Island University Hospital overcharged Medicare an estimated $11.8 million for inpatient and outpatient services billed over a two-year period, according to a recent Office of Inspector General (OIG) report.
While technological solutions and electronic health records have made leaps and bounds over the past years in the inpatient setting, there still seems to be much lacking on the outpatient side. Learn how to leverage existing technology to track Hierarchical Condition Category capture and other coding metrics.
Pacemakers are small devices implanted in the chest to help regulate inconsistent heart rates. Lori-Lynne A. Webb, CPC, CCS-P, CCP, CHDA, COBGC , breaks down documentation and CPT coding for pacemaker insertions, repairs, and relocations.
Hip and knee replacements are two of the most commonly performed elective surgeries, according to the American Academy of Orthopedic Surgeons. Review major joint anatomy and CPT coding for hip and knee revisions and replacements. Note : To access this free article, make sure you first register here if you do not have a paid subscription.
Refresh your knowledge of dysphagia, esophagitis, gastroesophageal reflux disease, and Barrett’s esophagus, and review guidance for reporting these conditions in ICD-10-CM.
National Correct Coding Initiative (NCCI) edits and Medically Unlikely Edits (MUE) can throw a wrench in the Medicare billing process, delaying appropriate revenue. Learn how to apply recent guidance and best practices to resolve challenging edits.
Approximately 34.2 million Americans, or 10.5% of the U.S. population, were diagnosed with diabetes in 2018, according to the Centers for Disease Control and Prevention. Review signs and symptoms of diabetes mellitus types 1 and 2 and ICD-10-CM coding for these conditions.
University of Michigan Health System overcharged Medicare an estimated $12.5k for polysomnography services submitted over a two-year period, according to a recent Office of Inspector General (OIG) report. Overpayments were due to insufficient documentation and CPT coding errors.
CMS withdrew the split/shared and critical care sections of the Medicare Claims Processing Manual and announced its intent to update coverage policies for these services. Prepare for changes to come by reviewing documentation, CPT coding, and billing guidance for split/shared and critical care services.
Medicare waivers and flexibilities allow providers to deliver care via telecommunication technology during the COVID-19 public health emergency (PHE). Judith Kares, JD , reviews CPT coding for e-visits, virtual communication services, and telephone E/M services.
CPT coding for psychotherapy and psychiatric diagnostic evaluations can be challenging, especially when these services are provided with office visits. Shelley C. Safian, PhD, RHIA, CCS-P , breaks down documentation and CPT coding for visit services provided with psychiatric care. Note : To access this free article, make sure you first register here if you do not have a paid subscription.
