Coding managers should not assume that they can review every coding guideline, Coding Clinic , or coding-related issue targeted by the Office of Inspector General. Review considerations for conducting focused internal and external audits.
Modifier -JW is used to describe drug amounts that are discarded and not administered to any patient. Refresh your knowledge of this modifier with coding tips and example scenarios.
Medication Therapy Management (MTM) is a group of services provided by pharmacists that involve active management of drug therapy. Review CPT coding, the role of pharmacists, and documentation tips associated with MTM.
Shelley C. Safian, PhD, RHIA, CCS-P, COC, CPC-I, unpacks local and national medical necessity standards and best practices for avoiding denials due to inadequate documentation .
Lori-Lynne A. Webb, CPC, CCS-P, CCP, CHDA, COBGC , describes the difference between an implant and a foreign body removal and outlines CPT coding for these procedures.
Physician service modifier -FT for unrelated E/M visits provided on the same day has been a source of confusion for many coding and billing professionals. Review the latest coding and billing guidance for reporting this modifier.
Anxiety disorders are the most common mental illness in the U.S., according to the National Institute of Mental Health Statistics. Shelley Safian, PhD, RHIA, CCS-P, COC, CIC , breaks down ICD-10-CM coding for common types of anxiety disorders and psychotherapy treatments used to manage them.
Joe Rivet, Esq., CCS-P, CPC, CEMC, CHC, CCEP, CHRC, CHPC, CICA, CPMA, CAC, CACO , describes how to use Office of Inspector General audit reports to identify areas at risk for noncompliance and how to organize targeted internal reviews.
CMS recently released new HCPCS modifiers -FR, -FQ, -FS, and -FT for telehealth visits. Julia Kyles, CPC , breaks down reporting guidance for these new physician modifiers that took effect January 1.
Under certain circumstances, a service or procedure may be partially reduced or eliminated at the discretion of the physician. Read up on the correct application of hospital modifiers -52, -73, and -74 for reduced and discontinued procedural services.
The 2022 ICD-10-CM manual includes new codes for thrombotic microangiopathy (TMA)—a rare clinical syndrome defined by the presence of hemolytic anemia, organ dysfunction, and low platelets. Read up on TMA pathophysiology and diagnosis coding.
Organizations may opt to measure productivity using several methods, such as number of charts coded per day or per month, based on their needs, service lines, and other considerations. Some organizations use different productivity metrics for specific settings or account types.
Review new CPT codes 98975-98981 for the monitoring of non-physiologic patient data such as musculoskeletal system status, respiratory system status, and medication adherence.
Lori-Lynne A. Webb, CPC, CCS-P, CCP, CHDA, COBGC , breaks down CPT coding for subsequent hospital visits and services provided on the day of discharge from inpatient status.
Review documentation requirements and CPT coding for radiology services including computed tomography and x-ray scans, breast mammography, and bone length studies.
Medical practices in the U.S. are expanding treatment options for major depressive disorder to include transcranial magnetic stimulation (TMS). Laurie Bouzarelos, MHA, CPC, reviews the basics of TMS, types of providers who can deliver TMS, and ICD-10-CM/CPT coding for TMS delivery and management.
CMS recently released the 2022 National Correct Coding Initiative Policy Manual for Medicare Services . Julia Kyles, CPC , breaks down procedure-to-procedure and medically unlikely edits for a selection of new provider-based services.
The 2022 CPT code set includes 249 new codes that went into effect January 1. Review new CPT codes for spinal decompressions, cataract removals, auditory implantations, and more.
Shelley C. Safian, PhD, RHIA, CCS-P, COC, breaks down CPT coding for hearing assessments and for auditory osseointegrated implants used to treat certain types of hearing loss.
The American Medical Association recently updated the CPT code set to include 249 new and 93 revised codes, which go into effect January 1. Review significant updates the musculoskeletal, cardiovascular, and digestive chapters of CPT. Note : To access this free article, make sure you first register here if you do not have a paid subscription.
The American Medical Association recently updated the CPT code set to include 249 new and 93 revised codes, which go into effect January 1. Review significant updates the musculoskeletal, cardiovascular, and digestive chapters of CPT.
ICD-10-CM codes for traumatic fractures specify the type of bone injury, affected area of the body, and in some cases, the degree of soft tissue damage. Review orthopedic terminology and documentation requirements for traumatic fractures to resolve the coding challenges.
Four new CPT codes for principal care management services take effect January 1, 2022. Review documentation requirements and billing edits that will affect reporting of these new codes.
Joe Rivet, Esq., CCS-P, CPC, CEMC, CPMA, CICA, CHRC, CHPC, CHEP, CHC, CACO, CAC, reviews findings from a recent Office of Inspector General audit of claims for neurostimulator implantation surgeries and their implications for coders.
The fiscal year 2022 ICD-10-CM code set introduced 165 new codes, effective for encounters on or after October 1. Read about notable changes including new codes for anemia and thrombolysis, COVID-19-realted conditions, depression, and gastric metaplasia.
Transcatheter arterial septostomy and transcatheter intracardiac shunt procedures are used to treat congenital cardiac diseases that restrict blood flow and atrial communication. Review documentation requirements and CPT coding for these minimally invasive surgeries.
The fiscal year 2022 ICD-10-CM code set introduced 165 new codes, effective for encounters on or after October 1. Read about notable changes including new codes for anemia and thrombolysis, COVID-19-realted conditions, depression, and gastric metaplasia. Note : To access this free article, make sure you first register here if you do not have a paid subscription.
Kimberly A. Hoy, JD, CPC , summarizes proposed changes to physician coding and billing for therapy assistant services in the 2022 Medicare Physician Fee Schedule proposed rule.
The latest quarterly National Correct Coding Initiative (NCCI) update includes a reversal of procedure-to-procedure (PTP) edits that involve E/M codes along with new medically unlikely edits (MUE) for a series of COVID-19 vaccination codes. Review the changes, which went into effect on October 1.
Lori-Lynne A. Webb, CPC, CCS-P, CCP, CHDA, COBGC , breaks down CPT coding for diagnostic services performed during the second and third trimesters, and provides an overview of an obstetric (OB) hospitalist's role in caring for high-risk maternity patients.
ICD-10-CM coding for neuropathies can be challenging given the complexity of these diagnoses and associated complications. Demystify documentation requirements and ICD-10-CM coding for ischemic and hemorrhagic strokes, migraine headaches, and paralysis.
Lori-Lynne A. Webb, CPC, CCS-P, CCP, CHDA, COBGC , breaks down CPT coding for diagnostic services performed during the second and third trimesters, and provides an overview of an obstetric (OB) hospitalist's role in caring for high-risk maternity patients.
Lori-Lynne A. Webb, CPC, CCS-P, CCP, CHDA, COBGC , breaks down CPT coding for ancillary services provided by obstetric providers including targeted ultrasound services and maternal serum tests used to screen for fetal abnormalities.
CMS recently released the 2022 Medicare Physician Fee Schedule proposed rule, which introduces new guidelines for reporting split/shared visit services. Julia Kyles, CPC , analyzes how the changes would impact physician practices.
To select the most specific CPT codes for prenatal care, physician coders must have a solid understanding of complex guidelines for reporting pregnancy-related office visits. Lori-Lynne A. Webb, CPC, CCS-P, CCP, CHDA, COBGC , unpacks services included in the global obstetric package and CPT coding for routine prenatal care.
Review proposed updates to the CPT set for 2022, including new codes for chronic care management, laser interstitial thermal therapy, spinal anesthesia, and more.
CPT coding for vaginal and cesarean deliveries and postpartum care requires strong attention to detail. Lori-Lynne A. Webb, CPC, CCS-P, CCP, CHDA, COBGC , breaks down stages of delivery and CPT coding guidance for childbirth.
To select the most specific CPT codes for prenatal care, physician coders must have a solid understanding of complex guidelines for reporting pregnancy-related office visits. Lori-Lynne A. Webb, CPC, CCS-P, CCP, CHDA, COBGC , unpacks services included in the global obstetric package and CPT coding for routine prenatal care.
The 2022 Medicare Physician Fee Schedule (MPFS) proposed rule includes significant policy updates affecting physician coding and billing. Review proposals to decrease to the Medicare conversion factor, revise guidelines for critical care services, and loosen telehealth coverage requirements.
Read up on ICD-10-CM code updates for fiscal year 2022, including new codes for post-COVID-19 symptoms, social determinants of health, and poisonings by cannabis and synthetic cannabinoids.
Cardiovascular conditions affect the structure and function of the heart and are a leading cause of death in the U.S., according to the Centers for Disease Control and Prevention. This article details ICD-10-CM coding for common heart conditions and CPT coding for cardiac catheterization procedures.
The 2022 Medicare Physician Fee Schedule (MPFS) proposed rule includes significant policy updates affecting physician coding and billing. Review proposals to decrease to the Medicare conversion factor, revise guidelines for critical care services, and loosen telehealth coverage requirements.
Refresh your knowledge of dysphagia, esophagitis, gastroesophageal reflux disease, and Barrett’s esophagus, and review guidance for reporting these conditions in ICD-10-CM.
Approximately 34.2 million Americans, or 10.5% of the U.S. population, were diagnosed with diabetes in 2018, according to the Centers for Disease Control and Prevention. Review signs and symptoms of diabetes mellitus types 1 and 2 and ICD-10-CM coding for these conditions.
Laura Evans, CPC, and Julia Kyles, CPC, break down potentially confusing updates to the 2021 E/M guidelines, including new definitions for technical terms and revised guidance for reporting diagnostic laboratory testing with interpretation.
Laura Evans, CPC , and Julia Kyles, CPC , break down potentially confusing updates to the 2021 E/M guidelines, including new definitions for technical terms and revised guidance for reporting diagnostic laboratory testing with interpretation.
Facility E/M coding reflects the volume and intensity of resources utilized by the facility during patient encounters. Joe Rivet, Esq., CCS-P, CPC, CEMC, CHC, CCEP, CHRC, CHPC, CICA, CPMA, CAC, CACO , describes how facilities can create internal guidelines and point systems for determining E/M level section.
Coding for traumatic fractures is based on details about the broken bone and the event that caused the injury. Review ICD-10-CM codes and guidelines for reporting different types of traumatic fractures.