Q: Could you discuss or explain evaluating encounter billing vs. monthly billing for recurring outpatient services such as chemotherapy infusions or radiation oncology?
With providers continuing to expand clinical documentation improvement efforts into outpatient settings, ACDIS has published a position paper offering guidance to outpatient CDI departments for performing queries.
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.
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.
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.
Q: Our coding department has been reviewing the AHIMA Standards of Ethical Coding but were interested in learning more about standard seven. I didn’t realize that continuing education credits help with ethical coding.
The first week of December was National Influenza Vaccination Week, a week highlighting the importance of continuing flu vaccination, particularly through the holiday season. Peggy Blue, MPH, CCS, CCS-P, CPC, CEMC , writes about CPT coding for vaccinations and immunization administration.
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.
When faced with a claim denial, providers need to understand what is being denied and when an appeal is appropriate. This article outlines basic steps providers need to take before composing an appeal for a claim denial and helpful tips for successfully navigating through the appeals process.
Updates to the 2018 CPT Manual , set to go into effect January 1, include several additions, revisions, and deletions to E/M and anesthesia procedural code sets. Familiarize yourself with these coding changes to aid in accurate reporting and prevent disruptions to the claims process. Note: To access this free article, make sure you first register here if you do not have a paid subscription.
Providers will no longer be required to append modifier -GT (via interactive audio and video) to professional telehealth claims, effective January 1, 2018, according to a policy CMS finalized in the 2018 Medicare Physician Fee Schedule (MPFS) final rule.
Coding for respiratory conditions can be challenging, given the structural complexity of the upper and lower respiratory tracts. Refresh your knowledge of respiratory anatomy to aid in the accurate reporting of common respiratory diagnoses such as emphysema, asthma, and chronic bronchitis. Note: To access this free article, make sure you first register here if you do not have a paid subscription.
Each year, more than 2,000 Americans are diagnosed with mesothelioma— an aggressive and deadly type of cancer that develops in the lining of the lungs, abdomen, or heart. Debbie Jones CPC, CCA , writes about different types of mesothelioma and how they should be reported in ICD-10-CM.
HCCs aren’t new, but for many organizations, their impact hasn’t been apparent until recently. Organizations must educate staff on HCCs to ensure success under reimbursement methodologies such as the Quality Payment Program and Merit-based Incentive Payment System reimbursement.
Q: If only a central vein is treated when performing treatment for an arteriovenous fistula, is it correct to report CPT code 36901 since 36907 is an add-on code?
Review vascular anatomy and terminology in order to aid in accurately assign codes for interventional radiology procedures such as angioplasties, atherectomies, and lower extremity revascularizations. Note: To access this free article, make sure you first register here if you do not have a paid subscription.
While the 2018 OPPS final rule may be controversial for its payment cuts to drugs purchased through the 340B drug discount program, it contains several provisions supported by hospitals and other stakeholders.
A new private payer rate-based Clinical Laboratory Fee Schedule (CLFS) system is estimated to drastically reduce Medicare Part B lab payments in 2018. Valerie A. Rinkle, MPA, details how this revision will impact providers in outpatient settings and payers tied to the Medicare CLFS.
November, a month associated with the pleasure of eating, is also Stomach Cancer Awareness Month. In this article, Yvette M DeVay, MHA, CPC, CPMA, CIC, CPC-I, describes signs and symptoms of stomach cancer, and outlines best practices when assigning diagnostic and procedural codes for this disease.
