Evolving diagnostic terminology and a general lack of awareness surrounding gender fluidity can cause confusion for healthcare providers and coders. Review key considerations for the ICD-10-CM reporting of biological sex, gender identity, and other gender-related diagnoses. Note : To access this free article, make sure you first register here if you do not have a paid subscription.
In response to a formal request for information from industry stakeholders, CMS received 567 comments on ways to improve its Patients Over Paperwork Initiative, including many requests from hospital groups to simplify billing and prior approval requirements.
CMS proposed a new framework for the Merit-based Incentive Payment System (MIPS) intended to make the transition to value-based care easier for physicians. Read up on the proposed framework, MIPS Value Pathways (MVP), and its potential impact on patients and providers beginning in 2021.
When applying CPT modifiers -80, -81, and -82, physician coders must carefully consider details in the operative note. Lori-Lynne A. Webb, CPC, CCS-P, CCP, CHDA, COBGC , writes about the correct application of modifiers used to identify services performed by surgical assistants.
Drug administration is one of the most commonly performed procedures in outpatient departments; however, this topic continues to generate confusion for coders and providers alike. Brush up on CPT coding rules for intravenous (IV) injections, infusions, and hydration services. Note : To access this free article, make sure you first register here if you do not have a paid subscription.
The four organizations that make up the Cooperating Parties for ICD-10 recently approved the 2020 ICD-10-CM guidelines, which include updated guidance for reporting pressure-induced deep tissue damage, multiple drugs or medicinal substances, injuries and complications.
Q: A patient presents to a wound care clinic for assessment of a 15 sq. cm open wound. A nurse evaluates the wound and performs selective debridement. Would it be appropriate to bill an E/M code and if so, should we report modifier -25?
The 2020 Medicare Physician Fee Schedule proposed rule includes significant documentation and payment changes for outpatient office visits reporting using E/M codes 99202-99215. Beginning in 2021, these proposed updates could add billions of dollars to the national E/M revenue stream.
Atrial fibrillation (AF) is the most common type of heart arrhythmia, according to the Centers for Disease Control and Prevention. Shelley C. Safian, PhD, RHIA, CCS-P, COC, CPC-I , reviews outpatient coding for AF and surgical techniques used to treat the condition on a case-by-case basis.
Q: Suppose a patient comes in for psychological testing evaluation. The provider interprets the test results and patient data, prepares a report, and begins treatment planning. If the interactive feedback session is held several days later, how would this be reported using CPT codes?
CMS released the calendar year (CY) 2020 Medicare Physician Fee Schedule (MPFS) and OPPS proposed rules on July 29, introducing new CPT codes and extensive changes to documentation requirements for E/M office visits, and seeking commentary on how to overhaul MIPS and potentially undo its payment policy for drugs purchased through the 340B discount program.
Before starting an ambulatory or outpatient clinical documentation improvement (CDI) program, those tasked with the project must first create some universal definitions, so everyone is on the same page and speaking the same language.
Several surgical techniques can be used to excise or slow the growth of a paratubal cyst. Lori-Lynne Webb, CPC, CCS-P, CCP, CHDA, COBGC , describes the etiology of paratubal cysts and CPT coding for their treatment.
Physician coders need to know when it’s appropriate it apply modifier -25 for significant, separately identifiable E/M service. Lori A. Cox, MBA, CPC, CPMA, CPC-I, CEMC, CGSC, CHONC , reviews the correct application of this frequently misused modifier. Note : To access this free article, make sure you first register here if you do not have a paid subscription.
The ICD-10-CM Manual lists hundreds of code options for mental disorders with unique characters to specify symptoms and complications. This article breaks down outpatient coding for commonly reported mental health conditions, psychiatric assessments, and psychotherapy. Note : To access this free article, make sure you first register here if you do not have a paid subscription.
A Medicare billing study recently published in The Journal of Hand Surgery found that provider reimbursement for magnetic resonance imaging (MRI) and computed tomography (CT) scans of the upper extremities significantly decreased over the last decade.
Medicare appropriate use criteria (AUC) requirements, currently in a voluntary testing period, will become mandatory starting January 1, 2020. Denise Williams, COC, CHRI , shares insight and analysis on AUC reporting requirements to help facilities prepare for what’s to come.
CMS released the 2020 ICD-10-CM code set in May, adding 273 new codes effective for reporting beginning October 1. Shelley C. Safian, PhD, RHIA, CCS-P, COC , reviews new ICD-10-CM Z codes for factors influencing health status and Y codes for legal interventions.
