Nancy M. Enos, FACMPE, CPC-I, CPMA, CEMC, CPC , reviews 2021 proposals to E/M codes for office visits and other outpatient services and draft guidelines for the implementation of these changes.
Internal audits can reveal inconsistencies in provider documentation and coding, reporting errors, and fraudulent billing practices. Review internal auditing basics and advice from regulatory experts on how to effectively educate providers on audit findings. Note : To access this free article, make sure you first register here if you do not have a paid subscription.
Q: The 2020 ICD-10-CM update added several new codes for legal interventions. What are these codes, and can they be assigned based on nonphysician documentation?
U.S. District Judge Rosemary M. Collyer recently ruled that CMS exceeded its authority when it expanded a site-neutral payment policy that cut reimbursement for certain E/M services provided in previously excepted off-campus hospital clinics.
The fiscal year 2020 ICD-10-CM Official Guidelines for Coding and Reporting provide instructions for healthcare professionals on how to appropriately report complex diagnoses. Lori-Lynne A. Webb, CPC, CCS-P, CCP, CHDA, COBGC , writes about significant guideline updates that will impact facilities starting October 1.
If payment updates in the 2020 Medicare Physician Fee Schedule proposed rule are finalized, they will significantly impact physician reimbursement for x-ray and E/M CPT codes, among others. Review payment proposals and the specialties that would see the greatest impact.
The 2020 CPT update added new codes for the preparation and insertion of drug delivery devices, dry needling, and anesthetic nerve injection administration. Familiarize yourself with these and other updates before they go into effect January 1. Note : To access this free article, make sure you first register here if you do not have a paid subscription.
Gastrointestinal cancer is the fourth most common cancer in the U.S., according to the National Cancer Institute. Shelley C. Safian, PhD, RHIA, CCS-P, CPC-I, COC , writes about ICD-10-CM coding for colon cancer screening and CPT coding for diagnostic colonoscopies.
Perhaps the most momentous Quality Payment Program (QPP) news in the proposed 2020 Medicare physician fee schedule is the Pathways (MVP) version of the Merit-based Incentive Payment System (MIPS) — but that’s not happening until 2021.
While the calendar year 2020 OPPS proposed rule is shorter than in prior years (819 pages for the display version), the proposed policies therein pack a punch and may be thought of as a new day dawning for the future of hospital services.
Your heart may flutter when you’re nervous, but if this happens on a regular basis, it could be a sign of a serious heart condition. Atrial fibrillation (AF), a common and potentially fatal cardiovascular condition, is an irregular heartrate that can cause blood clots, stroke, and other heart-related complications.
CMS proposed a new framework for the Merit-based Incentive Payment System (MIPS) intended to make the transition to value-based care easier for physicians. Read up on the proposed framework, MIPS Value Pathways (MVP), and its potential impact on patients and providers beginning in 2021.
Evolving diagnostic terminology and a general lack of awareness surrounding gender fluidity can cause confusion for healthcare providers and coders. Review key considerations for the ICD-10-CM reporting of biological sex, gender identity, and other gender-related diagnoses. Note : To access this free article, make sure you first register here if you do not have a paid subscription.
When applying CPT modifiers -80, -81, and -82, physician coders must carefully consider details in the operative note. Lori-Lynne A. Webb, CPC, CCS-P, CCP, CHDA, COBGC , writes about the correct application of modifiers used to identify services performed by surgical assistants.
Drug administration is one of the most commonly performed procedures in outpatient departments; however, this topic continues to generate confusion for coders and providers alike. Brush up on CPT coding rules for intravenous (IV) injections, infusions, and hydration services. Note : To access this free article, make sure you first register here if you do not have a paid subscription.
Q: A patient presents to a wound care clinic for assessment of a 15 sq. cm open wound. A nurse evaluates the wound and performs selective debridement. Would it be appropriate to bill an E/M code and if so, should we report modifier -25?
Atrial fibrillation (AF) is the most common type of heart arrhythmia, according to the Centers for Disease Control and Prevention. Shelley C. Safian, PhD, RHIA, CCS-P, COC, CPC-I , reviews outpatient coding for AF and surgical techniques used to treat the condition on a case-by-case basis.
Even if a hospital is not a teaching hospital, it may have services that require National Clinical Trial (NCT) reporting. It is logical for revenue integrity leadership to own this issue, but an explanation of the requirements for NCT reporting should be shared with all staff within the revenue cycle so there is a better appreciation of the fact that clinical trial billing rules apply more broadly than merely just to research or clinical trial studies.
Behavioral health is a highly specialized area of coding that many coders and billers are unfamiliar with. There are hundreds of ICD-10-CM codes for mental disorders with unique characters to specify symptoms and complications.
Several surgical techniques can be used to excise or slow the growth of a paratubal cyst. Lori-Lynne Webb, CPC, CCS-P, CCP, CHDA, COBGC , describes the etiology of paratubal cysts and CPT coding for their treatment.
