Below is a complete listing of all Physician Services articles that have appeared in JustCoding News.
July 10, 2012
An anesthesia provider faces plenty of challenges: cancelled anesthesia, failed medical direction, monitored anesthesia care, time issues, invasive line placement rules, and start/stop times. Judy A. Wilson, CPC, CPC-H, CPCO, CPC-P, CANPC, CPC-I, CMRS, reviews some of the common challenges coders face when reporting anesthesia services.
January 3, 2012
Medicare Advantage plans rely on the Hierarchical Condition Categories (HCC) system for reimbursement. HCC payments are linked to the individual health risk profiles for the members in the plan. MA Plans use ICD-9-CM codes as the primary indicators of each member’s health status. Therefore, it is essential for MA plans to make sure that providers capture the complete diagnostic profile of patients through accurate and complete physician coding. Holly J. Cassano, CPC, explains why coders need to have a complete understanding of the HCC process and risk adjustment, as well as the effects on the provider, the member, the MA plan, and overall reimbursement.
November 1, 2011
Knowing how to use and apply the rules for modifier -62 (co-surgeons) is crucial for coders. CMS and other third party payers also have a very specific payment structure for modifier -62. Lori-Lynne A. Webb, CPC, CCS-P, CCP, CHDA, explains what the surgeons need to document for coders to append modifier -62.
July 26, 2011
The standby services CPT code 99360 seems to confuse many coders. But coders have no need to fear coding for a standby service. A coder just needs to know the rules. Lori-Lynne A. Webb, CPC, CCS-P, CCP, CHDA, helps take the fear out of coding for standby services.
March 22, 2011
Coders often overlook medical necessity in the evaluation and management (E/M) code assignment process. Glenn Krauss, BBA, RHIA, CCS, CCS-P, CPUR, PCS, FCS, C-CDIS, CCDS, explains why medical necessity is the undisputed eighth component in selecting a level of E/M service.
March 8, 2011
The introduction of ICD-10-CM is more than an “upgrade” from ICD-9-CM. It is a massive overhaul of the medical coding system, which brings with it wide-ranging consequences for the entire healthcare industry. Teri Gatchel, MBA, CPC, explains what you can do to prepare.
November 2, 2010
Physicians often share the work of a patient’s visit with a nonphysician provider (NPP). The utilization of NPPs is cost-effective process for physician practices because it saves money when NPPs do the majority of work when sharing patient care with a physician. Sharon Bolarakis, CPC, CPC-I, CPMA, explains what constitutes split-shared visits and how to code for them.
October 5, 2010
Cardiac rehabilitation (CR) and pulmonary rehabilitation (PR) programs must comply with the Medicare guidelines in order to receive payment. Physician supervision is one area where CMS includes very specific information that these types of programs must follow. Christine Garvey, FNP, MSN, MPA, FAACVPR, and Karen Lui, RN, MS, FAACVPR, detail CMS’ requirements and what coders should look for in the documentation.
July 27, 2010
Urodynamic studies are a coding challenge. Differing physician terminology, unique documentation requirements, and new combination codes make for complicated reporting of these diagnostic procedures. Abraham Morse, MD, MBA, and Cynthia A. Trapp, CHFP, CMPE, CPC, CPC-I, CCS-P, CHC, discuss how to code different types of urodynamic studies.
March 23, 2010
Despite increased scrutiny from CMS and private payers, many provider organizations continue to make costly mistakes in coding, documentation, and often in both. There’s no shortage of educational resources, of course. So what’s the problem? Jeannie Cagle, RN, BSN, CPC, Maggie M. Mac, CPC, CEMC, CHC, CMM, ICCE, and Adel Miles, CPC, share what they’ve seen and offer some advice.