Hospital Outpatient Articles

Below is a complete listing of all Hospital Outpatient articles that have appeared in JustCoding News.

  • Healthcare News: New survey reveals healthcare organizations? ICD-10 implementation progress

    June 25, 2013

    ICD-10 implementation is less than 16 months away, but a recent survey by TrustHCS and AHIMA reveals that 25% of responding healthcare organizations have not yet established an ICD-10 steering committee.

  • Q/A: Billing vasectomy and sperm analysis

    June 25, 2013

    Q: My question pertains to CPT® vasectomy code 55250. This code includes "unilateral or bilateral (separate procedure) including postoperative semen examination(s).” The CPT manualstates that a reference laboratory that performs the semen analysis may bill separately for this service. May we bill CPT code 89321 (semen analysis; sperm presence and motility of sperm, if performed.) in addition to 55250 when the laboratory performs the semen analysis and the surgeon only performs the vasectomy?

  • CMS proposes change to inpatient criteria

    June 25, 2013

    CMS is reexamining inpatient criteria because it has seen a significant increase in the number of patients spending more than 24 hours in observation. James S. Kennedy, MD, CCS, CDIP, and Kimberly Anderwood Hoy, JD, CPC, discuss CMS’ proposed changes and how they could affect outpatient observation services.

  • Audit your ED E/M criteria

    June 25, 2013

    Outpatient providers are beginning to see more and more medical necessity audits, especially in the ED and for evaluation and management (E/M) levels. Caral Edelberg, CPC, CPMA, CAC, CCS-P, CHC, AHIMA-Approved ICD-10-CM/PCS Trainer, and Joanne M. Becker, RHIT, CCS, CCSP, CPC, CPC-I, AHIMA approved ICD-10-CM/PCS trainer, review the guidelines for ED E/M services and highlight common audit risk areas.

  • Unraveling the confusion surrounding modifiers -58, -78, -79

    June 25, 2013

    Even experienced coders struggle to determine when to append modifiers -58, -78 and -79 because they are very similar in definition, but very different in scope and usage. Lori-Lynne A. Webb, CPC, CCS-P, CCP, CHDA, COBGC, reveals the nuances coders must understand to correctly use these modifiers.

  • Healthcare News: CMS issues instructions for splitting claims between ICD-9 and ICD-10

    June 11, 2013

    CMS released Special Edition MLN Matters® Article SE1325 to clarify split billing for certain institutional encounters that span the ICD-10 implementation date of October 1, 2014.

  • Spot physician and facility coding differences

    June 11, 2013

    Coders use the same CPT® codes to report outpatient services whether they are coding physician or facility services. Jaci Johnson, CPC,CPC-H,CPMA,CEMC,CPC- I, and Judy Wilson, CPC, CPC-H, CPCO, CPC-P, CPPM, CPCI, CANPC, CMRS, examine the similarities and differences between coding in the two settings.

  • Q/A: NCCI edits for drug administration

    June 11, 2013

    Q: We get an NCCI edit when billing an intramuscular/subcutaneous injection (CPT® code 96372) during the same encounter as billing an injection, infusion, or hydration. Should we append modifier -59 (distinct procedural service)? Does it matter if an IV line is already in place before intramuscular/subcutaneous administration?

  • Shrink radiation oncology coding confusion

    June 11, 2013

    To correctly code for radiation oncology services, coders need to understand the various elements of the treatment. ­Rebecca Vandiver, CPC, CPC-I, and Chandra Stephenson, CPC, CPC-H, CPMA, CPC-I, CANPC, CEMC, CFPC, CGSC, CIMC, COSC, analyze these complex services from a coding perspective.

  • ICD-10-CM: Improving clinical documentation in all settings

    June 11, 2013

    Clinical documentation improvement (CDI) initiatives often focus on inpatient documentation to ensure that documentation accurately reflects patient severity. Laura Legg, RHIT, CCS, explains how CDI efforts can also benefit outpatient coding.