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.
Q: If a patient comes into an outpatient facility for a surgical procedure and the physician evaluates the patient before performing the procedure, can you append modifier -25 to the E/M service?
Coders are on the front lines of claim submission and in a good position to foster compliance. Learn strategies to prevent fraud and abuse and encourage accurate documentation and billing within your outpatient facility. Note : To access this free article, make sure you first register here if you do not have a paid subscription.
At the 2018 American Hospital Association (AHA) Annual Membership Meeting on Monday, May 7, CMS administrator Seema Verma focused on the agency’s efforts to reduce regulatory burdens and continued move from a fee-for-service to value-based system.
Do you question how your compensation and work responsibilities compare to those reported by coders across the country? To see how you stack up, review results from JustCoding’s 2017 Coder Salary Survey . Note : To access this free article, make sure you first register here if you do not have a paid subscription.
Q: A patient receives treatment for two ulcers, one on his foot and one on his hip. The physician performs a subcutaneous debridement to treat the foot ulcer and a muscle debridement to treat the hip ulcer. How would this be reported?
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.
When planning to implement a coding auditing program, the type of reviews, focus areas, and review frequency must all be taken into consideration. Rose T. Dunn, MBA, RHIA, CPA/CGMA, FACHE, FHFMA, CHPS , details how to conduct an effective coding audit and ensure compliance with documentation requirements.
While oral arguments in the American Hospital Association’s (AHA) lawsuit against CMS for its cuts to 340B drug payments in the 2018 OPPS final rule don’t begin until May 4, providers may want to take steps now to preserve their appeal rights if the AHA’s lawsuit is successful.
One in 12 adults suffer from alcohol abuse or dependence, and more than half of adults have a family history of alcoholism or problem drinking. Adrienne Commeree, CPC, CPMA, CCS, CEMC, CPIP, outlines ICD-10-CM rules for substance use, abuse, and dependence, and diagnosis coding for alcohol-related conditions.
Coders and clinical documentation improvement specialists play a key role in the success of quality payment programs such as MIPS. This article describes the financial impact that hierarchical condition category coding has on provider reimbursement and the coder’s role in ensuring complete, accurate, and timely documentation. Note : To access this free article, make sure you first register here if you do not have a paid subscription.
Telehealth services continue to expand and claims for these services may already be under scrutiny by Medicare contractors. Debbie Mackaman, RHIA, CPCO, CCDS, writes about the differences between originating site and distant site services in addition to coding, billing, and reimbursement for telehealth services.
Q: If a patient is seen for a pressure ulcer on the foot related to diabetes, would you report a diabetes diagnosis code? If surgical debridement is performed and the patient receives treatment for their diabetes, can you charge for both an office visit and debridement?
It’s estimated that more than half a million people in the U.S. are diagnosed with Crohn’s disease. Debbie Jones, CPC, CCA , outlines symptoms and treatments for Crohn’s disease, as well as ICD-10-CM coding for the condition and associated complications.
Almost 70% of Americans are considered overweight or obese. Shannon E. McCall, RHIA, CCS, CCS-P, CPC, CPC-I, CEMC, CRC, CCDS , reviews ICD-10-CM coding and HCC risk adjustment for obesity.
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.
CMS held a listening session March 21 to gather input from stakeholders on potential updates to the E/M documentation guidelines. The current guidelines are considered outdated in light of medical advances and the advent of the electronic health record.
