Medical Coding and Billing Articles

by Find-A-Code and friends



recent articles

Select the title to see a summary and a link to the full article.

Coding Injections for Pain Management

|

Coding for pain management can get confusing. How many injections, the location, and when to use a modifier are all common questions. This article will cover some of the most common injections used in pain management. Trigger Point Injections Trigger point injections are reported by how many muscles are treated using an ...

tags  Specl: Emergency Medicine    Specl: General Surgery    Specl: Orthopedics    Specl: Pain Management    Specl: Primary Care|Family Care    Specl: Rheumatology    Specl: Skilled Nursing    Topic: CPT Coding    Topic: HCPCS Coding    Topic: Modifier Coding   

Modifier 50 — Four "Must Know" Tips For Getting Paid

|

Modifiers added to an HCPCS or CPT© code alters the code description, providing clarity about the service for proper claim processing and reimbursement. Here are four things you must know about modifier 50 to ensure proper payment. - Modifiers are either informational or payment related. Informational modifiers provide additional...

tags  Specl: All Specialties    Specl: Anesthesia|Pain Management    Specl: Cardiology|Vascular    Specl: Dental    Specl: Dermatology|Plastic Surgery    Specl: Emergency Medicine    Specl: Endocrinology    Specl: ENT|Otolaryngology    Specl: Gastroenterology    Specl: General Surgery    Specl: Home Health|Hospice    Specl: Interventional Radiology    Specl: Laboratory|Pathology    Specl: Oncology|Hematology    Specl: Ophthalmology    Specl: Oral and Maxillofacial Surgery    Specl: Orthopedics    Specl: Pediatrics    Specl: Radiology    Specl: Rheumatology    Specl: Urology|Nephrology    Topic: CPT Coding    Topic: Modifier Coding    Topic: Procedure Coding   

Coding with PCS When There is No Code

|

ICD-10-PCS covers ALMOST everything! But not quite! What if a body system does not contain a body part for toes or fingers? What about an elbow? When it does not cover what you are looking for, where do you turn?  To the guidelines, of course! There are ICD-10-PCS guidelines just as ...

tags  Specl: Skilled Nursing    Topic: Claims Processing    Topic: Hospital    Topic: ICD10CM Coding    Topic: Practice Management    Topic: Procedure Coding   

OIG Report Highlights Need to Understand Guidelines

|

A new OIG report once again highlights the necessity for organizations to fully understand requirements for reporting services and having proper documentation. The types of problems addressed in this report are ongoing issues for multiple types of services and specialties and for many different payers.

tags  Topic: Compliance    Topic: Documentation    Topic: OIG   

Office of Inspector General Says Medicare Advantage Organizations are Denying Services Inappropriately

|

We attended the recent virtual RISE National Conference and had the opportunity to listen to presenters share their knowledge about risk adjustment and HCC reporting and data validation. Among the presenters were representatives from the Office of Inspector General (OIG), who presented findings from encounter data from 2012-2016. They began ...

tags  Payer: CMS|Medicare    Topic: Medicare    Topic: OIG    Topic: Risk Adjustment   

New Grouper Added for Skilled Nursing

|

The additional grouper for Skilled Nursing, sometimes referred to as (PDPM), is used for classifying SNF patients in a covered Part A stay. This grouper is included with our Home Health Grouper.  Current groupers/calculators include: Home Health PDGM (Patient-Driven Grouping Model) Skilled Nursing Facility PDPM (Patient-Driven Payment Model) What is it? According to CMS, In ...

tags  Specl: Home Health|Hospice    Specl: Skilled Nursing    Topic: Assessment Tools   

Use the Correct Diagnosis Codes and Revenue Codes to Get Paid for PAD Rehab

|

The initial treatment in rehabilitation for patients suffering from Intermittent Claudication (IC) is Supervised Exercise Therapy (SET) for Symptomatic Peripheral Artery Disease (PAD).  Rehabilitation using SET involves the use of intermittent walking exercise, which alternates periods of walking to moderate-to-maximum claudication, with rest.   When reporting 93668 for peripheral arterial disease rehabilitation the following ...

tags  Specl: Cardiology|Vascular    Specl: Physical Medicine|Physical Therapy    Topic: Billing    Topic: Coding    Topic: CPT Coding    Topic: ICD10CM Coding   

Are NCCI Edits Just for Medicare?

|

The National Correct Coding Initiative (NCCI) edits were developed by CMS to help promote proper coding and control improper coding that leads to incorrect payments with part B claims. It is important to understand that NCCI edits do not include every possible code combination or every type of un-bundling combination. With that ...

tags  Specl: All Specialties    Specl: Anesthesia|Pain Management    Specl: Billing    Specl: Cardiology|Vascular    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: Pain Management    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    Specl: xFAC Specialty Panel Admin    Topic: Auditing    Topic: Billing    Topic: Coding    Topic: CPT Coding    Topic: Modifier Coding    Topic: MUE - Medical Unlikely Edit   

New Name Same Great Product! "HCC Plus"

|

tags  Topic: Risk Adjustment   

Payment Adjustment Rules for Multiple Procedures and CCI Edits

|

Surgical and medical services often include work that is required to be done prior to a procedure and post-procedure. When there are multiple procedures done by the same physician, group, or another qualified healthcare professional on the same day, the pre and post work is only required once. Therefore, CMS ...

tags  Payer: CMS|Medicare    Topic: Billing    Topic: CPT Coding    Topic: Denial Management    Topic: Fees    Topic: Modifier Coding    Topic: Payer Guidelines    Topic: Practice Management   

New ABN Form is Here

|

The anticipated changes to the Advanced Beneficiary Notice of Non-coverage (ABN) Form (CMS-R-131) have arrived. This important form is issued to the patient or client by providers, physicians, practitioners, and suppliers in situations where Medicare payment is expected to be denied. You can begin using the new ABN immediately if you so wish. However, it becomes mandatory on August 31, 2020.

tags  Topic: ABN - Advanced Beneficiary Notice    Topic: HIPAA    Topic: Medicare    Topic: Practice Management   

Understanding UCR Inpatient Fees used on DRGs

|

tags  Specl: Skilled Nursing    Topic: Care Coordinator    Topic: Claims Processing    Topic: Coding    Topic: Fees    Topic: Hospital    Topic: Payment Models    Topic: Practice Management   

HCPCS Codes Were NOT all Created for the Same Purpose

|

Have you ever wondered why you were unable to find a particular product/code with our DMEPOS search? When looking for HCPCS Level II codes, there are several kinds of codes and not all HCPCS codes were created for the same purpose. If you are searching for a certain HCPCS product ...

tags  Topic: Billing    Topic: CDT (Dental) Codes    Topic: Coding    Topic: DME    Topic: HCPCS Coding   

Additional COVID-19 Testing Codes Announced

|

New coronavirus antigen testing codes announced. These are effective immediately.

tags  Topic: Code Updates    Topic: Coding    Topic: COVID-19    Topic: CPT Coding    Topic: Procedure Coding   

CMS- Reminder COVID Assessment and Specimen Collection

|

On March 1, 2020, new codes and rules were released to bill for COVID-19 symptom and exposure assessments, as well as specimen collection. CMS has recently sent out reminders on billing for these services, the proper use of the CS modifier on claims, and how they are handling denials due ...

tags  Topic: COVID-19    Topic: CPT Coding   

Should I Bill Dental or Medical?

|

While you likely find yourself focusing on fewer patients and more on emergency care, it’s a good time to understand how medical billing can allow patients with active infection in the oral cavity to seek the treatment they need.  Forms need to be filled out correctly, and you must carefully follow ...

tags  Specl: Dental    Specl: Oral and Maxillofacial Surgery   

Newest Launch - We Now Have Outpatient Facility Pricing!

|

Our newest feature launch offers UCR pricing for Outpatient Facility. We recently released pricing information based on databases of insurance claims from private-sector health care providers.Usual, customary, and reasonable charges (UCR) are medical fees used when there are no contractual pricing agreements and are used by certain healthcare plans and third-party payers to generate ...

tags  Specl: Skilled Nursing    Topic: Billing    Topic: Care Coordinator    Topic: Coding    Topic: CPT Coding    Topic: Fees    Topic: Physician Billing    Topic: Practice Management    Topic: Reimbursement   

Medical Necessity using Soap can prevent a future audit!

|

Medical Necessity using Soap can prevent a future audit! How Do I Correctly Document all my notes on every patient regardless of the insurance I am billing? Medically necessary care is the reasonable and essential diagnostic, preventive, and treatment services (including supplies, appliances, and devices) and follow-up care as determined by qualified ...

tags  Specl: Dental    Specl: Oral and Maxillofacial Surgery   

MEGA - NCCI Edit Changes - WHO Knew?

|

There was no huge announcement when CMS released new files in April. The files that were released on April 7, 2020, actually replaced files to update the NCCI edits on Procedure to Procedure (PTP) edits and Medically Unlikely Edits (MUE).  The updated files included; 291,902 Deleted Procedure to Procedure (PTP) edits 197  Deleted Medically Unlikely ...

tags  Specl: All Specialties    Topic: Coding    Topic: CPT Coding    Topic: Diagnosis Coding    Topic: Guidelines and Manuals    Topic: Medicare    Topic: Modifier Coding    Topic: MUE - Medical Unlikely Edit   

Proposed Risk Adjustment Changes

|

On June 2, 2020, HHS published two proposed changes to the Risk Adjustment Data Validation (RADV) protocols for HHS-Operated Risk Adjustment Programs.

tags  Topic: Risk Adjustment   

articles by subject

articles by specialty

articles by payer

articles by location



articles by month

   




Past articles

Many of the following articles have been tagged with the tags shown above. These are displayed here again for historical purposes.

The following articles are published here and elsewhere on the Internet. If you would like to publish one of these articles on your website, please contact us and let us know which article you would like to publish and where you will be publishing it.

Articles: ICD-10

Articles: Medical Coding

Articles: Medical Billing

Articles: Medical Billing and Coding (General)

article requests

If you would like a specific article written on a medical coding and billing topic, please contact us.


contact

innoviHealth Systems, Inc.
62 East 300 North
Spanish Fork, UT 84660
Phone: 801-770-4203 (9-5 Mountain)
Email:
free demo
request yours today
pricing
for any budget
sign IN
welcome back!

Thank you for choosing Find-A-Code, please Sign In to remove ads.