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Recent articles:Click on the title to see the article summary and a link to the full article. August 21st, 2019 A Coder’s Insight into Diagnosis Coding| Published August 21st, 2019
To assign an accurate diagnosis code, you need the most specific ICD-9- CM code available for a documented condition and the same will be true when ICD-10 becomes our coding system. Now is the time, if you haven’t already, to look at how you chooseyour codes and to work with ... Tags: Topic: CPT Coding Topic: Denial Management Topic: Diagnosis Coding Topic: Procedure Coding August 21st, 2019 So How Do I Get Paid for This? APC, OPPS, IPPS, DRG?| Published August 21st, 2019 You know how to find a procedure code and you may even know how to do the procedure, but where does the reimbursement come from? It seems to be a mystery to many of us, so let's clear up some common confusion and review some of the main reimbursement systems. One of the ... Tags: Topic: Facilities Topic: Fees Topic: Hospital Topic: Payment Models August 20th, 2019 Attention Chiropractors!| Published August 20th, 2019
Find-A-Code has created a TOPIC page specifically for Chiropractors. Check it out! We have simplified your search with Articles, Tips, Webinars, and Tools all in one place for your convenience.
Be sure to visit us today. Simply go to Findacode.com then hover over TOPICS at the top of the page, then select Chiropractic.
... Tags: Specl: Chiropractic August 20th, 2019 Are You Aware of Medicare Advantage Plans Timely Filing Rules?| Published August 20th, 2019 The Medicare Fee for Service (FFS) program (Traditional or Original Medicare) has a timely filing requirement; a clean claim for services rendered must be received within one year of the date of service or risk payment denial.
As any company who has billed Medicare services can attest, the one-year timely filing ... Tags: Loc: All Locations Payer: All Payers Payer: CMS|Medicare Specl: All Specialties Topic: Appeals Topic: Billing Topic: Coding Topic: Compliance Topic: CPT Coding Topic: Denial Management Topic: Insurance Topic: Medicare Topic: Medicare Secondary Payer Topic: Payer Guidelines Topic: Practice Management Topic: Reimbursement August 20th, 2019 A Step by Step Guide to Medical Billing| Published August 20th, 2019 The next 4 weeks we will be providing you with a step by step guide to why medical billing is now part of our Dental future.
Dental surgery is performed to treat various conditions of the teeth, jaws, and gums. Surgical procedures that dentists perform include dental implants, treatment for temporomandibular ... Tags: Specl: Dental Specl: Oral and Maxillofacial Surgery August 19th, 2019 Understanding Payment Indicators| Published August 19th, 2019 Understanding how payment works with Medicare payment indicators and the impact a modifier has on payment is vital to pricing. Even if you are not billing Medicare, most carriers follow Medicare's policies for participating and non-participating rules. Here is an article from Regence on their policy statement, describing the rules ... Tags: Topic: Coding Topic: CPT Coding Topic: Facilities Topic: Modifier Coding August 16th, 2019 Medical ID Theft| Published August 16th, 2019 - Last Review/Update August 20th, 2019 Medical ID Theft
"So, do you guys think you can do something with that?" John asked angrily at our first meeting with him in August 2017 as he slammed a stack of medical bills, EOBs and collection letters - three inches high - down in front of my partner and I. ... Tags: Specl: Acupuncture|Alternative Specl: Allergy|Immunology Specl: Ambulance Specl: Anesthesia|Pain Management Specl: Behavioral Health|Psychiatry|Psychology Specl: Billing Specl: Cardiology|Vascular Specl: Chiropractic Specl: Dental Specl: Dermatology|Plastic Surgery Specl: Emergency Medicine Specl: Endocrinology Specl: ENT|Otolaryngology Specl: Gastroenterology Specl: General Surgery Specl: Home Health|Hospice Specl: Internal Medicine Specl: Interventional Radiology Specl: Neurology|Neurosurgery Specl: Obstetrics|Gynecology Specl: Ophthalmology Specl: Optometry Specl: Oral and Maxillofacial Surgery Specl: Orthopedics Specl: Pediatrics Specl: Physical Medicine|Physical Therapy Specl: Pulmonology Specl: Radiology Specl: Rheumatology Specl: Skilled Nursing Specl: Urology|Nephrology August 13th, 2019 How to Properly Report Prolonged Evaluation and Management Services| Published August 13th, 2019 Have you ever had a patient take more time with the provider than they were scheduled for? Do you understand which codes to report and the rules that govern them to allow for better reimbursement?
Prolonged Service codes were created just for that reason but you must carefully follow the documentation ... Tags: Loc: All Locations Payer: All Payers Specl: All Specialties Specl: Behavioral Health|Psychiatry|Psychology Topic: Billing Topic: Coding Topic: CPT Coding Topic: E+M Documentation and Coding Topic: Procedure Coding August 13th, 2019 Healthcare Common Procedure Coding System (HCPCS)| Published August 13th, 2019 There are three main code sets and Healthcare Common Procedure Coding System (HCPCS), is the third most common code set used. They are often called Level II codes and are used to report non-physician products supplies and procedures not found in CPT, such as ambulance services, DME, drugs, orthotics, supplies, ... Tags: Topic: CDT (Dental) Codes Topic: Denial Management Topic: Diagnosis Coding Topic: DME Topic: HCPCS Coding August 13th, 2019 Will Medicare Change Their Rules Regarding Coverage of Services Provided by a Chiropractor?| Published August 13th, 2019 Two separate pieces of legislation introduced in the House of Representatives (H.R. 2883 and H.R. 3654) have the potential to change some of Medicare’s policies regarding doctors of chiropractic. Find out what these two bills are all about and how they could affect Medicare policies. Tags: Payer: CMS|Medicare Specl: Chiropractic Topic: Compliance Topic: CPT Coding August 13th, 2019 Q/A: I Billed 2 Units of L3020 and Claim was Denied. Why?| Published August 13th, 2019 Question:
We billed 2 units of L3020 but were denied for not using the right modifiers. What should we do?
Answer:
Rather than submitting two units of the L3020 to indicate that the patient one orthotic for each foot, you would need to use modifiers identifying left foot and right foot. Appropriate coding ... Tags: Topic: HCPCS Coding Topic: Modifier Coding August 9th, 2019 The OIG Work Plan: What Is It and Why Should I Care?| Published August 9th, 2019 - Last Review/Update August 14th, 2019 The Department of Health and Human Services (HHS) founded its Office of Inspector General (OIG) in 1976 and tasked it with the responsibility to combat waste, fraud, and abuse within Medicare, Medicaid, and the other HHS programs. With approximately 1,600 employees, HHS OIG is the largest inspector general's office within ... Tags: Specl: Acupuncture|Alternative Specl: All Specialties Specl: Allergy|Immunology Specl: Ambulance Specl: Anesthesia|Pain Management Specl: Behavioral Health|Psychiatry|Psychology Specl: Billing Specl: Cardiology|Vascular Specl: Chiropractic Specl: Dental Specl: Dermatology|Plastic Surgery Specl: Emergency Medicine Specl: Endocrinology Specl: ENT|Otolaryngology Specl: Gastroenterology Specl: General Surgery Specl: Home Health|Hospice Specl: Internal Medicine Specl: Interventional Radiology Specl: Laboratory|Pathology Specl: Neurology|Neurosurgery Specl: Obstetrics|Gynecology Specl: Oncology|Hematology Specl: Ophthalmology Specl: Optometry Specl: Oral and Maxillofacial Surgery Specl: Orthopedics Specl: Pediatrics Specl: Physical Medicine|Physical Therapy Specl: Podiatry Specl: Primary Care|Family Care Specl: Pulmonology Specl: Radiology Specl: Rheumatology Specl: Skilled Nursing Specl: Urology|Nephrology Topic: Compliance Topic: Medicaid Topic: Medicare Topic: OIG August 6th, 2019 CMS Proposes to Reverse E/M Stance to Align with AMA Revisions| Published August 6th, 2019 On July 29, 2019, CMS released their proposed rule for the Medicare Physician Fee Schedule for 2020. Last year’s final rule “finalized the assignment of a single payment rate for levels 2 through 4 office/outpatient E/M visits beginning in CY 2021.” It also changed some of the documentation requirements (e.g., ... Tags: Topic: CPT Coding Topic: E+M Documentation and Coding Topic: HCPCS Coding Topic: Procedure Coding August 6th, 2019 Q/A: What if my Patient Refuses to Fill out the Outcome Assessment Questionnaire?| Published August 6th, 2019 Question:
What if my Medicare patient refuses to fill out the outcome assessment questionnaire?
Answer:
Inform the patient that Medicare requires that you demonstrate functional improvement in order for them to determine if the care is medically necessary. In other words, they may have to pay for the care out of pocket if ... Tags: Specl: Chiropractic Topic: Assessment Tools Topic: Documentation August 2nd, 2019 The Slippery Slope For CDI Specialists| Published August 2nd, 2019 - Last Review/Update August 8th, 2019 Who knew that when Jack & Jill when up the hill to fetch a pail of water, they would have to ensure that in order to keep the level of water the same on the way back down, they would need to both support the pail.
Many of you in this industry are ... Tags: Payer: CMS|Medicare Specl: Billing Topic: Auditing Topic: Medicare July 29th, 2019 The Role of Chiropractic in Value Based Payment Systems| Published July 29th, 2019 Chiropractic care can play a valuable role in overall patient health. It is important to realize that chiropractors can effectively participate in Medicare's new value based payment systems. Read about one organization who has made this transition. Tags: Specl: Chiropractic Topic: Health Care Reform Topic: Practice Management July 29th, 2019 Q/A: How do I Bill Mobile Clinic Services?| Published July 29th, 2019 Question: I have a part time mobile clinic. I travel to treat patients at their homes. Are there special considerations when billing for these encounters? Tags: Specl: Chiropractic Topic: Billing Topic: Coding July 26th, 2019 Anthem is Changing their Timely Filing Requirements for All Plans, Including Medicare Advantage| Published July 26th, 2019 - Last Review/Update August 8th, 2019 Anthem has been very busy sending out notices stating that, beginning October 1, 2019, all timely filing deadlines for claims will be 90 days. We've seen this letter, or something very similar, sent to doctors and other healthcare providers from California to Kentucky.
In their notice, Anthem states:
"Effective for all commercial ... Tags: Payer: Aetna Payer: CMS|Medicare Specl: All Specialties Topic: Claims Processing July 23rd, 2019 Tips to Preventing Audits| Published July 23rd, 2019 - Last Review/Update July 30th, 2019 There is an ever-increasing number of dental claims that have come under scrutiny for fraud. One such payer, Aetna, is actively pursuing dental fraud by employing their special investigative units (SIUs) to identify and investigate providers who demonstrate unusual coding and billing practices. When payers identify the activities they deem ... Tags: Specl: Dental Specl: Oral and Maxillofacial Surgery Topic: Auditing July 22nd, 2019 Q/A: What do I Need to Document for Periodic Adjustments on a Medicare Patient?| Published July 22nd, 2019 Question:
What type of documentation is required for a Medicare patient with degenerative joint disease who get adjusted once or twice a month for occasional flare-ups of the D. J. D. region? The noted adjustments give good relief of the patient's symptoms.
Answer:
There is no question that these adjustments would be considered ... Tags: Specl: Chiropractic Topic: Documentation Topic: Medicare |
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