2012 CLFS Update Addresses New Molecular Pathology Codes
The 2012 annual update to the Clinical Laboratory Fee Schedule (CLFS) is anything but a quick read. In addition to the 2012 CLFS update, a Recurring Update Notification (RUN) provides instructions for...
View ArticleAvoid Billing Surprises: Know What’s Covered in Preventive Visits
Most patients don’t realize the differences among screening, diagnosis, and treatment. When a patient comes into the office for a preventive visit and it turns into acute care, many patients think...
View ArticleBe Aggressive with Same-day E/M and Office Procedure
Fight for your right to be paid for properly documented claims. By G.J. Verhovshek When commenting on Abraham Morse’s, MD, MBA, article “Same-day E/M and Office Procedure: Yes, You Can!” (March 2012...
View ArticleAlign Coding with Video-assisted Thoracic Surgery Advances
2012 introduces new codes for both diagnostic and surgical VATS. By Laurette Pitman, RN, CPC-H, CGIC, CCS Due to advances in surgical procedures, video-assisted thoracoscopic surgery (VATS) has an...
View ArticleKeep in Step with SEP and MEP
CPT® 2012 revises intraoperative neurophysiologic monitoring code usage for surgery. By Gloria Galloway, MD, FAAN Use of intraoperative neurophysiologic monitoring (IONM) has increased over the last...
View ArticleStrengthen Your Diagnosis Coding for Risk Adjustment
By Serine A. Haugsness, CPC The concept of risk adjustment was “born” upon passage of the Balanced Budget Act of 1997 and refined by the Beneficiary Improvement Act of 2000, which mandated that the...
View ArticleFactor HCC with a Two-pronged Approach to Risk Adjustment
By Holly J. Cassano, CPC Proper hierarchal condition category (HCC) classification depends on a plan’s ability to obtain accurate diagnostic HCC information and report that information accurately to...
View ArticleEHRs Coding Urgent Care Come at a High Price
By Thomas A. Maher, CPA, CPC Are you intrigued at the prospect of reducing your medical claims coding costs? Have you heard the promise of an electronic health record (EHR) that will eliminate your...
View ArticleDiagnostic Specificity Is Key to Payment Accuracy for MA Plans
By Holly J. Cassano, CPC Accurate payment under the Centers for Medicare & Medicaid Services (CMS) risk adjustment reimbursement model depends on diagnosis code specificity and reporting all...
View ArticleOvercome ICD-10-CM Documentation Challenges
By Jacqueline J. Stack, BSHA, CPC, CPC-I, CEMC, CFPC, CIMC, CPEDC No doubt you’ve heard that moving to ICD-10-CM will give you more specific choices for coding diagnoses. This data-driven code set will...
View ArticlePhysicians Practice: Proper Coding Can Help Prove Medical Necessity
Submitting claims for payment can be challenging; a provider must document the diagnosis reported to help support medical necessity of the procedure. AAPC Director of Education Raemarie Jimenez, CPC,...
View ArticleTop 10 Medicare Risk Adjustment Coding Errors
By Carol Olson, CPC, CPC-H, CPC-I, CEMC, CCS, CCS-P, CCDS Medicare Advantage (MA) reimbursement can trip you up in ways you didn’t expect. If you are seeing MA patients, be mindful of opportunities and...
View ArticleEffective Hypertension Documentation Is in the Detail
By Kathy Philp, CPC Medical records documentation tells the relevant story of a patient in a way that even a provider who has never met the patient can understand. That level of detail may sound like a...
View ArticleCatch Up on Hematology and Oncology in ICD-10-CM
Know your guidance to maintain compliant coding. By Elizabeth Wernet, CPC, CHONC ICD-10-CM and the ICD-10-CM Official Guidelines for Coding and Reporting 2014 bring new guidance for hematology and...
View ArticleWatch Out for Misused EHR Documentation Shortcuts
Knowing the risks EHRs pose is the first step to improving E/M documentation. By Ellen Risotti-Hinkle, CPC, CPC-I, CPMA, CEMC, CFPC, CIMC The use of electronic health records (EHRs) is steadily...
View ArticleState Regulations Matter when Reporting HIV to Payers
Understand consent laws and other factors that affect HIV diagnosis coding. By G.J. Verhovshek, MA, CPC, and Renee Dustman Q : I’ve been told that, depending on the patient’s insurance carrier, a...
View ArticleA&P Tip: Juvenile Arthritis
By Rhonda Buckholtz, CPC, CPMA, CPC-I, CENTC, CGSC, COBGC, CPEDC Juvenile arthritis, which includes juvenile rheumatoid arthritis and juvenile idiopathic arthritis, is the most common type of arthritis...
View ArticleCMS Releases ICD-10-CM to HCC Mappings
Linda R. Farrington, CPC, CPMA, CPC-I Look at your common clinical conditions, ICD-10-CM requirements, and note changes. On April 6, 2015, the Centers for Medicare & Medicaid Services (CMS)...
View ArticleWhat Not to Say to Patients
Being tactful when patients are worried about ailments or a diagnosis isn’t always easy for a physician. Sometimes, what they say can make the situation more stressful. According to Physicians...
View ArticleConfounded By ICD-10 Excludes1 Notes? Here’s Why
The National Center for Health Statistics (NCHS), the federal agency responsible for the use of the newly-implemented ICD-10 diagnosis code set in the United States, posted interim advice on its...
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