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.
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.
Coding for pain management requires a detailed understanding of medical anatomy and terminology as well as the guidelines for reporting complex surgical procedures. Review ICD-10-CM coding for chronic and acute pain diagnoses and CPT coding for trigger point, joint, and epidural steroid injections. Note : To access this free article, make sure you first register here if you do not have a paid subscription.
A July 2018 update to the OPPS clarifies that coders can report HCPCS code C9749 for an inherently bilateral procedure with modifiers -73 or -74 to indicate that the procedure was unilateral. Debbie Mackaman, RHIA, CPCO, CCDS, unpacks this seemingly contradictory guidance and addresses implications for coding and billing professionals.
Understanding when and how to report hospital modifiers is critical to ensuring compliant billing. Review CPT guidelines for modifiers -25, -50, and -59, as well as case studies and denial numbers by specialty, to reduce your risk from audits. Note : To access this free article, make sure you first register here if you do not have a paid subscription.
Cognitive impairment ranges from mild to severe and can impact a person’s ability to perform everyday functions such as talking, remembering, and comprehending information. Debbie Jones, CPC, CCA , reviews CPT and ICD-10-CM coding, and care planning for patients living with cognitive impairment.
Cancer is the second most common form of death in the U.S., according to the Centers for Disease Control. To accurately report CPT and ICD-10-CM codes for skin and breast cancer, coders need a thorough understanding of symptoms of malignancies and treatments used to prevent them from spreading. Note : To access this free article, make sure you first register here if you do not have a paid subscription.
Predicting CMS policies can be a foolhardy exercise, especially with a relatively new administration and frequent turnover at the highest levels of HHS over the last year. But it’s safe to say drug payment policy has been and will continue to be a focus of the current regime.
A recent report from the Office of Inspector General focuses on improper payments for specimen validity tests billed in combination with urine drug tests. Yvette DeVay, MHA, CPC, CPMA, CIC, CPC-I, reviews Medicare instructions and coding guidance for presumptive and definitive drug testing.
Pelvic congestion syndrome is a chronic medical condition affecting millions of women between the ages of 20 and 45. Lori-Lynne Webb CPC, CCS-P, CCP, CHDA, COBGC, ICD-10-CM/PCS , reviews symptoms of the condition and reporting using CPT and ICD-10-CM codes.
Every year, more than 30 million people in the United States are diagnosed with sinusitis, otherwise known as a sinus infection. Debbie Jones, CPC, CCA, reviews signs and symptoms of sinusitis and CPT coding for procedures used to treat the infection.
CMS recently released MLN Matters SE18001 to provide healthcare practitioners with instructions and coding guidance for specimen validity when performed and billed in combination with drug testing. The article was issued to remind laboratories and other providers performing urine drug testing that specimen validity testing (SVT) is not separately billable.
According to the National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK), it is estimated that more than half a million people in the U.S. have Crohn’s disease. For unknown reasons, the disease has become more widespread in both the U.S. and other parts of the world.
A coding audit may be conducted by internal staff or external entities, typically representing the insurers paying for the care. When planning to implement a coding auditing program, the type of reviews, focus areas, and review frequency must all be taken into consideration.
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.
Providers should be preparing for another rulemaking cycle from CMS as we hit April, with the IPPS rule expected to include a discussion on how the existing payment system can address new and emerging cellular and gene therapies.