Health information management, Hospital inpatient, Hospital outpatient
This report from HIM Briefings (formerly Medical Records Briefing) looks at trends that may emerge in 2016 and what your organization may want to focus on.
This hierarchy also supersedes parenthetical instructions for add-on codes that in some cases may suggest an add-on of a higher hierarchical position to be reported in conjunction with a base code of a lower position, according to the CPT Manual.
Modifier -GA is used to indicate that a waiver of liability statement that is required by the payer is on file. Modifier -GX is used to describe a voluntary waiver of liability. Use -GY to describe an item or service that is statutorily excluded or that does not meet the definition of any Medicare benefit. Use -GZ to describe an item or service expected to be denied as not reasonable and necessary.
Jugna Shah, MPH, founder and president of Nimitt Consulting, and Valerie A. Rinkle, MPA, Associate Director, Healthcare for Navigant Consulting answered these five additional questions about injections and infusions coding.
Gloria Miller, CPC, CPMA, vice president of reimbursement services at Comprehensive Healthcare Solutions, Inc., based in Tacoma, Wash., answered these questions about hospital outpatient wound care coding.
Payers often refer to these examples to determine the appropriate level of service for an emergency medicine claim. Caral Edelberg, CPC, CPMA, CAC, CCS-P, CHC, AHIMA-Approved ICD-10-CM/PCS Trainer, president of Edelberg Compliance Associates of Baton Rouge, La., created this reference chart of examples for both CPT and American College of Emergency Physician Guidelines. If your claim is consistent with a case example but coded differently, be sure you have the supporting information in the record.
