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Medical Coding and Billing Articles


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Federal Workers Compensation Information

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When federal employees sustain work-related injuries, it does not go through state workers compensation insurance. You must be an enrolled provider to provide services or supplies. The following are some recommended links for additional information about this program. Division of Federal Employees' Compensation (DFEC) website Division of Federal Employees' Compensation (DFEC) provider ...

tags  Specl: Acupuncture|Alternative    Specl: All Specialties    Specl: Anesthesia|Pain Management    Specl: Behavioral Health|Psychiatry|Psychology    Specl: Chiropractic    Specl: Neurology|Neurosurgery    Specl: Ophthalmology    Specl: Physical Medicine|Physical Therapy    Specl: Podiatry   

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CMS and HHS Tighten Enrollment Rules and Increase Penalties

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This ruling impacts what providers and suppliers are required to disclose to be considered eligible to participate in Medicare, Medicaid, and Children's Health Insurance Program (CHIP). The original proposed rule came out in 2016 and this final rule will go into effect on November 4, 2019.  There have been known problems ...

tags  Specl: All Specialties    Specl: Chiropractic    Topic: Medicare   

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Spotlight: UCR Fees are Available on DRGs- Check it Out!

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Check out the information page on any DRG! Look up DRGs by going to the list of DRG codes found under the Codes tab at the top of the page, or simply type in the desired DRG by using the search bar on the homepage. When using the search bar, be sure you have the ...

tags  Topic: Fees   

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E-Health is a Big Deal in 2020

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The new 2020 CPT codes are on the way! We are going to see 248 new codes, 71 deletions, and 75 revisions. Health monitoring and e-visits are getting attention; 6 new codes play a vital part in patients taking a part in their care from their own home. New patient-initiated ...

tags  Topic: E+M Documentation and Coding    Topic: Procedure Coding   

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Chiropractic 2020 Codes Changes Are Here

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There are some interesting coding changes which chiropractic offices will want to know about. Are codes that you are billing changing?

tags  Topic: CPT Coding    Topic: Diagnosis Coding    Topic: ICD10CM Coding    Topic: Procedure Coding   

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Q/A: Is the Functional Rating Index by Evidence-Based Chiropractic Valid?

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Question Is the Functional Rating Index, from the Institute of Evidence-Based Chiropractic, valid and acceptable? Or do we have to use Oswestry and NDI? Answer You can use any outcome assessment questionnaire that has been normalized and vetted for the target population and can be scored so you can compare the results from ...

tags  Specl: Chiropractic    Topic: Assessment Tools   

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List of Cranial Nerves

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Cranial nerves are involved with some of our senses such as vision, hearing and taste, others control certain muscles in the head and neck. There are twelve pairs of cranial nerves that lead from the brain to the head, neck and trunk. Below is a list of Cranial Nerves and ...

tags  Specl: Neurology|Neurosurgery    Specl: Ophthalmology    Specl: Physical Medicine|Physical Therapy   

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So How Do I Get Paid for This? APC, OPPS, IPPS, DRG?

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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   

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Attention Chiropractors!

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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   

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Are You Aware of Medicare Advantage Plans Timely Filing Rules?

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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   

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A Step by Step Guide to Medical Billing

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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   

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Understanding Payment Indicators

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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   

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Medical ID Theft

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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   

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How to Properly Report Prolonged Evaluation and Management Services

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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   

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Healthcare Common Procedure Coding System (HCPCS)

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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   

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Will Medicare Change Their Rules Regarding Coverage of Services Provided by a Chiropractor?

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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   

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Q/A: I Billed 2 Units of L3020 and Claim was Denied. Why?

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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   

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The OIG Work Plan: What Is It and Why Should I Care?

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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   

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CMS Proposes to Reverse E/M Stance to Align with AMA Revisions

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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   

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Q/A: What if my Patient Refuses to Fill out the Outcome Assessment Questionnaire?

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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   

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Articles: ICD-10

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