CMS recently released Transmittal 4246 , revising language in Chapter 13 of the Medicare Claims Processing Manual regarding the billing of E/M codes on the same date of service as superficial radiation treatment delivery.
CMS added new guidance to the CPT Manual to clarify imaging documentation for codes that include both procedural and imaging guidance. This article outlines these regulatory changes and implications for outpatient coders and providers.
Prostate cancer is the second most common form of cancer in American men, according to the American Cancer Society. Shelley C. Safian, PhD, RHIA, CCS-P, CPC-I , writes about CPT coding for rectal exams and a new prostate specific antigen (PSA) immunoassay test used to detect early indications of prostate cancer, as well as ICD-10-CM codes used to support medical necessity for these services.
Outpatient coders and billers must be able to interpret potentially confusing documentation elements for drug administration services and know what to do when key elements, such as infusion time, are missing from an order. Review CMS guidance on the accurate reporting and billing of intravenous drug administration services for calendar year 2019. Note : To access this free article, make sure you first register here if you do not have a paid subscription.
The American Hospital Association (AHA) and the U.S. Department of Health and Human Services (HHS) recently issued court-ordered briefs in which each defends its respective position in a federal 340B payment lawsuit. The case was brought against HHS by multiple hospital groups to reverse Medicare payment cuts for drugs purchased through CMS' 340B drug discount program.
Arthroscopic procedures allow surgeons to use minimally invasive arthroscopic techniques to treat conditions which previously required more intensive, open surgery. Learn about orthopedic anatomy and terminology and CPT guidelines for reporting arthroscopic hip and knee procedures. Note : To access this free article, make sure you first register here if you do not have a paid subscription.
Q: A physician performs a hemiarthroplasty for a hip fracture. Would this procedure be reported with CPT code 27125 (hemiarthroplasty, hip, partial [e.g., femoral stem prosthesis, bipolar arthroplasty])?
Review advice from experts on accurate documentation and CPT coding for chronic care management, knee injection services, and health and behavior assessments.
In the current healthcare climate the issue of medical necessity documentation, or lack thereof, is one of the most common reasons for claim denials. Review medical necessity guidance from CMS and learn how to prevent repeated denials due to improper documentation of medical necessity. Note : To access this free article, make sure you first register here if you do not have a paid subscription.
Q: Can you bill CPT codes 76981 (ultrasound, elastography; parenchyma [e.g., organ]) and 76982 (ultrasound, elastography; first target lesion) at the same time as CPT codes for liver and breast ultrasounds?
A recent study conducted by physician researchers at Stanford University highlights the challenges of CPT code-based patient classification and subsequent outcome analysis for colorectal procedures.
CMS has downgraded the supervision requirements for services performed by radiologist assistants working in medical practices, imaging centers, and radiology offices. Read about these 2019 changes to ensure accurate documentation and reporting for radiology services.
The beginning of a new year typically brings new resolutions to deal with weight-related issues. Shelley C. Safian, PhD, RHIA, HCISPP , writes about ICD-10-CM coding for common weight-related diagnoses such as obesity and anorexia, and CPT coding for interventions used to treat them.
Lori-Lynne A. Webb, CPC, CCS-P, CCP, CHDA, COBGC , reviews common CPT and ICD-10-CM coding and documentation errors, such as unbundling, inappropriate modifier usage, and missing information, to help coders reduce their risk from audits.
The ICD-10-CM Manual was recently updated with new codes for peritonitis in association with acute appendicitis and the CPT Manual now includes new codes for gastrostomy tube replacements. Familiarize yourself with these changes to ensure accurate reporting of digestive diagnoses and treatments. Note : To access this free article, make sure you first register here if you do not have a paid subscription.
Findings show that pathologist involvement in the review and verification of CPT codes may reduce the need for code modifications at the time of sign-out auditing, according to the recent study published in the Archives of Pathology and Laboratory Medicine.
Even on a small scale, the implementation of an outpatient clinical documentation improvement (CDI) program can be overwhelming. Review advice from CDI specialists on developing successful outpatient CDI programs that facilitate accurate coding and billing.