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Recent articles:Click on the title to see the article summary and a link to the full article. September 14th, 2017 Double Dipping in the History of the Evaluation and Management Note| Published September 14th, 2017 There are many rules and guidelines a coder must be aware of when it comes to appropriately selecting an Evaluation and Management (EM) code and avoiding doubling dipping is one of them. Double dipping occurs when the same information is used in more than one of the subcomponents of history.
The subcomponents of history include:
Chief Complaint ... Tags: Loc: All Locations Payer: All Payers Specl: All Specialties Topic: Auditing Topic: Coding Topic: Compliance Topic: CPT Coding Topic: Documentation Topic: E+M Documentation and Coding Topic: Fraud September 13th, 2017 How to Properly Report Prolonged Evaluation and Management Services| Published September 13th, 2017 - Last Review/Update September 18th, 2017
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 Topic: CPT Coding September 12th, 2017 Auditing Prolonged Evaluation and Management Services| Published September 12th, 2017 - Last Review/Update September 18th, 2017
At times, there are patients who require prolonged face-to-face time with the provider to discuss or be counseled about their condition, plan of care, risks, complications, alternative therapies, or other medical issues. When E/M services go wild, taking significantly longer than the typical time associated with it, that direct face-to-face ... Tags: Loc: All Locations Payer: All Payers Specl: All Specialties Topic: CPT Coding Topic: E+M Documentation and Coding September 11th, 2017 Dental Providers- So what are ICD 10 codes?| Published September 11th, 2017
What has been your definition so far when asked about how they are different? What does an ICD-10 code look like? How does an ICD-10 code work?
Have you seen commercials about medical coding schools and wonder if the profession is right for you? With the field expected to grow faster ... Tags: Specl: Dental Topic: Billing Topic: ICD10CM Coding August 29th, 2017 Elderly Abuse Discovered by the OIG - Early Alert| Published August 29th, 2017
The OIG sent out an early alert in an effort to create awareness to potential abuse or neglect of Medicare Beneficiaries in skilled nursing facilities. The OIG identified 134 Medicare beneficiaries whose injuries may have been the result of potential abuse or neglect. The beneficiaries reported were treated at the ... Tags: Specl: Primary Care|Family Care Specl: Skilled Nursing August 29th, 2017 Quality Measures for Chiropractic - 2017| Published August 29th, 2017
Performance Measurement Codes for Chiropractic:
Although there are hundreds of Performance Measurement (PM) services and events, only two may be reported for chiropractors for the 2017 reporting year.
Pain Assessment and Follow-Up
131
ENCOUNTER: 90791, 90792, 92002, 92004, 92012, 92014, 92507, 92508, 92526, 96116, 96118, 96150, 96151, 97161, 97162, 97163, 97164, 97165, 97166, 97167, ... Tags: Topic: CDT (Dental) Codes Topic: CPT Coding Topic: HCPCS Coding Topic: Quality Payment Program August 23rd, 2017 Funding Extended for Veterans Choice Program| Published August 23rd, 2017
The Veterans Choice Program, created in 2014, was part of the solution to the extensive waiting times found in the VA system. The program allowed veterans to meet their health care needs from private health care providers. Though the “sunset” of the program was avoided earlier in the year, the ... Tags: Payer: VA - Veterans Administration Specl: All Specialties Topic: Insurance August 23rd, 2017 VA Patient-Centered Community Care and Veterans Choice Program: Worth it for Providers?| Published August 23rd, 2017 As the opportunities for providers outside the VA system expand in order to meet demand, you may be interested in offering services to veterans and the VA, if you are not already. With overwhelming bipartisan support, the opportunities are not likely to abate, but are those opportunities worth it for ... Tags: Payer: VA - Veterans Administration Specl: All Specialties Topic: Insurance August 17th, 2017 The First Phone Call to Your Office| Published August 17th, 2017
The telephone has a huge impact on your practice. The very first phone call to your office will be the beginning of the patient relationship to the practice, and if not handled correctly may potentially be the last.
https://www.dentalcare.com/en-us/practice-management/scripting/use-a-telephone-script-scripting-conversations
Chose your words carefully.
https://www.dentalcare.com/en-us/practice-management/scripting/raise-the-energy-level-with-a-power-words-list
Welcome: https://www.dentalcare.com/en-us/practice-management/scripting/dental-scripts-scripting-the-patient-welcome
Scheduling. It shapes everyone’s day and has a direct ... Tags: August 17th, 2017 Looking at Site Selection Variables – For Chiropractic Tenants| Published August 17th, 2017 When you’re looking for the right property for your new chiropractic practice or wish to expand or move your practice, having a checklist of desirable criteria can help you stay on track. As The Lease Coach, we appreciate and applaud tenants who provide a detailed checklist of what they are looking for in each location.
You should weigh many demographic aspects when considering leasing a location in a certain area or territory. Just because you’ve found a new property with space for lease doesn’t mean the demographics will fit your ideal criteria. As a chiropractic tenant, the following points will be specifically important to you when searching: Tags: Topic: Misc August 17th, 2017 Medicare Announces New Cards to Be Issued| Published August 17th, 2017
Identity theft has become a major problem in the United States. As a prevention measure, the Centers for Medicare& Medicaid Services (CMS) is readying a fraud prevention initiative that removes Social Security numbers from Medicare cards to help combat identity theft, and safeguard taxpayer dollars.
Personal identity theft affects a large ... Tags: Topic: Medicare August 16th, 2017 TCM, CCM, and Clinical Staff Members| Published August 16th, 2017
When auditing Transitional Care Management (TCM) and Chronic Care Management (CCM) services, you may come into a situation where services are performed by clinical staff members. What constitute as a clinical staff member, and are they allowed to perform such services? What if they are not licensed?
CMS is vague about ... Tags: Topic: Auditing August 16th, 2017 The Importance of Time, Timelines, and Timing with Your Commercial Lease – For Medical Professional Tenants| Published August 16th, 2017
Readers of our new book, Negotiating Commercial Leases & Renewals FOR DUMMIES, will learn (in part) that the leasing process can take differing amounts of time, depending on whether you’re opening your first or fifth location. You can discover a lot during your first few lease deals that you can ... Tags: Topic: Practice Management August 16th, 2017 If It’s Not a Consultation, What Is It?| Published August 16th, 2017
You thought you had a consultation supported in your documentation, and now you find out that you cannot bill the consultation codes (99241-99245, 99251- 99255). So, what are the top reasons for a consultation not to be supported?
If the payer does not support these codes
If the documentation does not support ... Tags: Topic: Auditing Topic: CPT Coding Topic: Modifier Coding August 16th, 2017 Case Law Update: Just Because HIPAA Does Not Provide a Private Right of Action, Doesn't Mean that Other Avenues Exist| Published August 16th, 2017 - Last Review/Update September 13th, 2017
August 4, 2017
Case Law Update: Just Because HIPAA Does Not Provide a Private Right of Action, Doesn't Mean that Other Avenues Exist
Simply stated, the Health Information Portability and Accountability Act (HIPAA) does not provide a private cause of action[1]. And, prior to the 2009 passage of the Health Information Technology ... Tags: Topic: HIPAA August 15th, 2017 United HealthCare Ending Consultation Reimbursements: Effective October 1st, 2017| Published August 15th, 2017
While Medicare discontinued payment allowance for consultation services (ranges 99241-99245 and 99251-99255) in January 2010, many commercial carriers have continued to cover these services. United Healthcare is now joining Medicare's opinion on consultation services.
In the June 2017 edition of the United HealthCare Bulletin, United Healthcare has announced that effective October ... Tags: Topic: CPT Coding Topic: E+M Documentation and Coding August 15th, 2017 Transparency and Fees| Published August 15th, 2017 More than any other industry, healthcare is almost notorious for its lack of price transparency. While patients generally know how much their copay will be and certainly how much their final bill turns out to be, few hospitals and practices publish the actual costs of their services prior to those ... Tags: Specl: Dental Topic: Fees Topic: Practice Management August 11th, 2017 Chart Auditing For Beginners| Published August 11th, 2017
In the new year, have you found yourself in the new role of performing internal chart audits for your organization? Are you often finding yourself saying "Now What?!" First, take a deep breath and start with the basics. In this week's tip, I will review the very basic tips and ... Tags: Topic: Auditing August 11th, 2017 Injury, Poisoning, and Certain Other Consequences of External Causes (S00-T88)| Published August 11th, 2017
There is important information that must be included when documenting injuries and external cause codes in ICD-10-CM. There are expanded sections on poisonings and toxins making it more convenient to code, as ICD-10-CM is very specific.
When using a code from Chapter 19 (Injury, Poisoning and Certain other Consequences of External ... Tags: Topic: ICD10CM Coding August 11th, 2017 Do Other States Lower Payments for Crowns by Delta or Blue Cross?| Published August 11th, 2017
Question: A subscribers from the State of Michigan has asked this:
Has anyone from other states seen the fees for crowns lowered by Delta or Blue Cross?
Answer: First look at your contracts, and see if there is anything in it that allows for fees to be lowered. Next, look up your ... Tags: Specl: Dental Topic: CDT (Dental) Codes Topic: CPT Coding |
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