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JustCoding.com provides coders, coding supervisors, and health information management (HIM) directors with educational resources to test their coding knowledge, employ correct coding guidelines, and stay abreast of CMS transmittals. To learn about the different levels of access to this site, click here.
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Auditing for coding mistakes on outpatient orthopedic cases
Auditors often focus on evaluation and management (E/M) services and don’t spend quite as much time reviewing surgical services. However, auditors should shine their spotlight on surgical services from time to time. If coded incorrectly, resulting payment errors could be much larger than those for E/M services, and have a more significant effect on an organization’s revenue. Jillian Harrington, MHA, CPC, CPC-P, CPC-I, CCS-P, discusses coding for knee arthroscopies and fracture care as well as place-of-service coding.
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To take advantage of the new Medicare benefits for cardiac and pulmonary rehab services, coders must use the correct codes for these services. Karen Lui, RN, MS, FAACVPR, and Jane Schulz, RRT, FAACVPR, explain the coding and timing requirements for cardiac and pulminary rehab programs.
CDI programs can greatly enhance documentation. But what happens when a hospital's risk-adjusted complication index and/or risk-adjusted mortality index rise as a result of perceived complications that aren't actually complications? Robert S. Gold, MD, and Lena Wilson, MHI, RHIA, CCS, explain how this can happen when coders report complication codes for conditions that are unrelated to the surgery or that existed prior to the surgery. They also provide guidance for how to determine what truly constitutes a complication.
Navigating the waters of the 10-day global period for minor surgeries can be a headache for providers and coders alike. Even more frustrating is trying to understand what codes to report for services provided during the global period. Dawson Ballard Jr., CCS-P, CPC, addresses the guidelines for reporting both related and unrelated services during and after the global period.
Reviewing billing and coding changes for this year will help boost your bottom line and cut denials. Shelley C. Safian, MAOM/HSM, CCS-P, CPC-H, CPC-I, CHA, gives a run down of numerous changes labs should take note of, including new codes, new guidance, and some deleted codes.
E codes get a makeover in ICD-10
March 9, 2010
While teaching the inpatient and outpatient boot camps, I often receive questions regarding ICD-10. One of them that sticks out in my mind is, "What about E codes? Are they still going to look the same?" So I decided to do some research. How will we refer to the "external cause" or E codes (as we [...]
CMS provider call to address ICD-10 requirements
March 5, 2010
Don’t miss CMS’ upcoming national provider conference call on March 23 from 1-2:30 PM EST.This National Provider Conference Call will provide an overview of ICD-10-CM/PCS requirements and a basic introduction to ICD-10-CM. CMS representatives will discuss the following topics: Requirement to report ICD-10-CM/PCS codes for services provided on or after October 1, 2013 ICD-9-CM codes will not [...]
ICD-10 includes guidelines for mental disorder codes
March 1, 2010
For several years, our ICD-9 manuals have indicated that the guidelines for Chapter 5 concerning Mental Disorders have been reserved for future expansion. Well, they went from no guidelines in the ICD-9 manual to a single paragraph of guidelines in the ICD-10 manual. The guidelines state: Pain disorders related to psychological factors Assign code F45.41, for pain that [...]
Healthcare News: CMS issues special edition Q&A about reporting physician consultation services
March 10, 2010
On March 1, CMS released MedLearn Matters Special Edition Article SE1010, “Questions and Answers on Reporting Physician Consultation Services,” for physicians and non-physician practitioners who perform initial evaluation and management services, previously reported with CPT® consultation codes for Medicare beneficiaries. Read more to learn about the Q&As CMS issued.
Healthcare News: CMS posts HIPAA version 5010 fact sheets and checklists
March 3, 2010
CMS posted fact sheets and checklists on its Web site to help guide providers through the transition to HIPAA version 5010, which providers must implement by January 1, 2012. The transition to HIPAA 5010 is a necessary prelude to the implementation of ICD-10 in 2013.
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Check out what you're missing on JustCoding Platinum!
A new tool in the Sample policies and forms section:
- CPT coding resource: Lesion excision
Continuing education credits: To receive a 0.5 CE credit, take the quiz after reading the following articles:
- Auditing for coding mistakes on outpatient orthopedic cases
- Combat potential undercoding due to fear of RAC denials
- Correctly code for new cardiac, pulmonary rehab benefits
- Healthcare News: CMS issues special edition Q&A about reporting physician consultation services
- Q&A: Coding for procedure to remove splinter in the ED
Editor’s note: Please note that on March 24, we will remove the following course from the JustCoding e-learning library: JCPL030: Nonphysician practitioners. If you would like to take this course for credits, please do so before March 24.
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March 19, 2010
Outpatient Coding and Billing for Devices: Apply the Rules Correctly for Appropriate Reimbursement
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