Medicare covers two caregiver training services that are similar enough to cause confusion, claims errors and denials.
For example, behavior management training (96202-96203) and the separate training that shows caregivers how to assist patients who have functional deficits (97550-97552) both include time-based code pairs.
Health information management, Hospital inpatient, Hospital outpatient
Use this Antibiotic Efficacy Table to aid in identification of antibiotics by brand name and their effectiveness against gram-negative and gram-positive bacteria.
Auditing and monitoring, Health information management, Hospital outpatient, Physician practice, Training
Reporting discussion of management or test interpretation
Count discussions that meet the E/M definition. A “discussion of management or test interpretation” can earn a moderate or high score under the data review element of an E/M office visit. But before you give the billing practitioner credit for a discussion, make sure the documentation shows that it met the definition of a discussion.
Use the illustrated guide on discussions to train staff.
Auditing and monitoring, Clinical documentation, Training
This resource takes a retrospective look at the CDI profession in terms of compensation, industry projection, advancements, new hires, and other data points.
Health information management, Hospital outpatient, Training
Coders should make sure their physicians and qualified healthcare professionals (QHP) are ready for the crucial role in reporting HCPCS Level II code G0136 (administration of a standardized, evidence-based social determinants of health [SDOH] risk assessment tool, 5-15 minutes, not more often than every 6 months).
While practices can perform a SDOH assessment for all of its patients, members of the medical team will take the lead in identifying patients who meet Medicare’s requirements for the billable service.
Share the following illustration with providers to help them negotiate Medicare’s rules. This tool was originally published on Part B News.
Coders had to review and update their training materials for split/shared visits for physician reporting when CMS completely revamped the rules in 2022. It wouldn’t hurt to do so again with this tool to make sure they match the CMS rules and CPT manual guidelines that went into effect January 1, 2024.
Auditing and monitoring, Hospital outpatient, Training
This resource deconstructs the components of the revenue cycle and explains how coding affects denials and reimbursement. This resource was created by Laurie Bouzarelos, MHA, CPC, of Provider Solutions.
Auditing and monitoring, Hospital outpatient, Physician practice
CMS and other federal agencies opened up telehealth coverage policies during the COVID-19 public health emergency (PHE). Even though the PHE came to an end May 11, 2023, virtual care options (otherwise known as "teleheath" services) remain popular. From coverage rules and compliance tips, this guide will help coders and providers navigate the world of remote patient monitoring services.
