Joe Rivet, Esq., CCS-P, CPC, CEMC, CHC, CCEP, CHRC, CHPC, CICA, CPMA, CAC, CACO , describes how to use Office of Inspector General audit reports to identify areas at risk for noncompliance and how to organize targeted internal reviews.
Providers can now code for E/M visits based solely on medical decision-making. Julia Kyles, CPC , outlines how to use the first column of the medical decision-making chart in the CPT Manual to determine E/M level selection.
Following the release of the Medicare Payment Advisory Commission’s March report to Congress, the American Medical Association (AMA) urged Congress to revise the Medicare Physician Fee Schedule (MPFS) to include stable, annual payment updates that keep up with inflation and practice costs.
Arterial embolization is less invasive than open surgery and is often performed as an outpatient procedure in a hospital setting. Lori-Lynne A. Webb, CPC, CCS-P, CCP, CHDA, COBGC, evaluates medical necessity and CPT coding for uterine artery embolization.
Anxiety disorders are the most common mental illness in the U.S., according to the National Institute of Mental Health Statistics. Shelley Safian, PhD, RHIA, CCS-P, COC, CIC , breaks down ICD-10-CM coding for common types of anxiety disorders and psychotherapy treatments used to manage them. Note : To access this free article, make sure you first register here if you do not have a paid subscription.
Patients are often admitted for acute conditions and experience additional issues affecting their care and treatment plan during the encounter. Ashayla Stephens, MHA, RHIA, CCS , and Audrey Howard, RHIA , describe the process of validating multiple diagnoses documented within the health record. Note : To access this free article, make sure you first register here if you do not have a paid subscription.
The primary purpose of CDI work is to review medical records to increase the accuracy and specificity of provider documentation. Review the primary responsibilities of a CDI specialist including documentation review, querying, and physician education.
A recent audit conducted by the Office of Inspector General (OIG) found that Tufts Health Plan Inc. (Tufts) received at least $3.7 million of net overpayments from 2015 to 2016 for incorrectly submitting selected high-risk diagnosis codes.
Physician documentation of heart failure must specify the type and severity of the illness to apply the most accurate code. Alba Kuqi, MD, MSHIM, CDIP, CCS, CCDS, CRCR, CICA, CSMC, RHIA, CCM , breaks down clinical documentation and ICD-10-CM coding for four types of heart failure.
Under certain circumstances, a service or procedure may be partially reduced or eliminated at the discretion of the physician. Read up on the correct application of hospital modifiers -52, -73, and -74 for reduced and discontinued procedural services.
CMS recently announced a new HCPCS Level II code for COVID-19 convalescent plasma administered in the outpatient setting, effective for claims submitted on or after December 28, 2021.
CMS recently released new HCPCS modifiers -FR, -FQ, -FS, and -FT for telehealth visits. Julia Kyles, CPC , breaks down reporting guidance for these new physician modifiers that took effect January 1.
To assign the most specific CPT codes for spinal procedures, coders need a solid understanding of spinal anatomy and surgical terminology. Review spinal anatomy and CPT coding for vertebral corpectomies, discectomies, laminectomies, and more. Note : To access this free article, make sure you first register here if you do not have a paid subscription.
Organizations may opt to measure productivity using several methods, such as number of charts coded per day or per month, based on their needs, service lines, and other considerations. Some organizations use different productivity metrics for specific settings or account types.
CDI specialists must be able to apply both clinical and coding knowledge in order to discern relevant clinical conditions, and they must be able to analyze the quality of provider documentation and identify any gaps or inconsistencies in information between the health record and the associated data.
