Support: FAQs, tutorials, videos, page index and more
Medical Billing and Coding, ICD-10-CM, ICD-10-PCS, CPT, HCPCS, etc.
> Home > Info
Viewing:  Aug 17, 2017

Medical Coding and Billing Articles

Recent articles:

Click on the title to see the article summary and a link to the full article.

TCM, CCM, and Clinical Staff Members

|

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   

Read the article →

The Importance of Time, Timelines, and Timing with Your Commercial Lease – For Medical Professional Tenants

|

 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   

Read the article →

If It’s Not a Consultation, What Is It?

|

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   

Read the article →

United HealthCare Ending Consultation Reimbursements: Effective October 1st, 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   

Read the article →

Transparency and Fees

|

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   

Read the article →

Chart Auditing For Beginners

|

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   

Read the article →

Injury, Poisoning, and Certain Other Consequences of External Causes (S00-T88)

|

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   

Read the article →

Do Other States Lower Payments for Crowns by Delta or Blue Cross?

|

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   

Read the article →

Collect More Cash from Patients

|

One of the easiest things a practice can do to increase collections makes it easier for patients to pay by whatever method they have available at the time of the visit, says Christine Taxin Adjunct Professor at NYU Dental School and Owner of Links2Success.biz.

Tags:  Specl: Dental    Topic: Practice Management   

Read the article →

List of Common Unclassified Injectable drugs (this list in not all-inclusive)

|

This is a list of some of the most common Injectable unclassified drugs used with J3490   Antilirium – 1 mg/ml Ascorbic Acid – 500 mg/ml Ascorbic Acid – 250 mg/ml Bacitracin, Intramuscular – 50,000 unit vials Bacitracin, Intramuscular – 10,000 unit vials Brevital Sodium – 500 mg/5 ml Caffeine and Sodium Benzoate – 250 mg/ml Capastat Sulfate – 1 ...

Tags:  Topic: Claims Processing    Topic: HCPCS Coding    Topic: Pharmaceutical   

Read the article →

Searching With the Comprehensive Search Tool

|

Occasionally, when a customer searches for a code with key words with the comprehensive search, we get feedback that they are not getting the correct results. Some of the main reasons are the correct code set is not selected in the search box. Other times customers are not searching the keywords and notes. ...

Tags:  Topic: Admin    Topic: Coding    Topic: ICD10CM Coding   

Read the article →

Increased Medicare payment rates for FY 2018!

|

We can look forward to a few prospective payments for Skilled Nursing Facilities, Hospice and Inpatient Rehab; CMS released their final rule and reported on key highlights of the new FY 2018 Medicare payment rules. CMS States, “The 2018 Skilled Nursing Facility (SNF) Prospective Payment System Final Rule increases Medicare payment rates ...

Tags:  Specl: Home Health|Hospice    Specl: Physical Medicine|Physical Therapy    Specl: Skilled Nursing    Topic: Medicare   

Read the article →

Cybersecurity - Are you sure you are secure?

|

An article by Medical Economics highlights the June report of the Health Care Industry Cybersecurity Task Force. Their report confirmed once again that healthcare providers are not adequately addressing cybersecurity as part of the compliance programs. The threat of hackers is very real and providers need to ensure that they have taken ...

Tags:  Specl: All Specialties    Topic: Compliance    Topic: HIPAA   

Read the article →

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 for Economic and Clinical Health Act (HITECH Act)[2] and the more robust chain of liability (e.g. covered entities, business associates and ...

Tags:  Topic: HIPAA   

Read the article →

Veterans Choice Program

|

In 2017, President Trump signed into law changes to the Veteran's Choice program, which allows veterans to seek care from a civilian (privately contracted) healthcare provider, closer to home, when obtaining care through the VA has become burdensome to the veteran or requires the veteran to wait too long for an appointment.

Tags:  Payer: VA - Veterans Administration    Specl: All Specialties    Topic: Health Care Reform    Topic: Insurance    Topic: Reimbursement   

Read the article →

How to Bill a Dressing Change

|

A dressing change may not be billed as either a debridement or other wound care service under any circumstance (e.g., CPT 97597, 97598, 97602). Medicare does not separately reimburse for dressing changes or patient/caregiver training in the care of the wound. These services are reimbursed as part of a billable procedure code that, commonly but not necessarily, ...

Tags:  Specl: General Surgery    Specl: Primary Care|Family Care    Topic: CPT Coding   

Read the article →

Requirements for Physicians Orders for DME/HCPCS

|

Effective July 1, 2013, certain DME/HCPCS codes require a valid detailed written order prior to delivery. There are very specific rules and requirements requiring medical necessity and orders/prescriptions. It is also required to keep a copy in the patients chart. If billing CMS and commercial payers payers, the DME prescribed may be denied ...

Tags:  Topic: HCPCS Coding   

Read the article →

Compliance Program - What are the Requirements to Implement an Effective Program?

|

All sponsors are required to adopt and implement an effective compliance program, which must include measures to prevent, detect, and correct Part C or D program non-compliance as well as FWA. The compliance program must, at a minimum, include the following core requirements:  1. Written Policies, Procedures, and Standards of Conduct;  2. Compliance Officer, Compliance Committee, ...

Tags:  Specl: Dental   

Read the article →

HIPAA Training Requirements

|

HIPAA Training must be an ongoing effort in every healthcare organization.

Tags:  Topic: Compliance    Topic: HIPAA   

Read the article →

Annual Wellness Visit (AWV)

|

Annual Wellness Visits (AWVs) are a preventive medicine service. It is a comprehensive evaluation and management service which is covered by payers as part of the Affordable Care Act (ACA)'s covered services and there are typically no deductibles or co-pays.

Tags:  Specl: All Specialties    Topic: CPT Coding    Topic: HCPCS Coding    Topic: Health Care Reform    Topic: Risk Adjustment   

Read the article →

Articles by Subject: 

Articles by Specialty: 

Articles by Payer: 

Articles by Location: 


Articles by Month

Select year and month:     



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

Our contact information:

Find A Code, LLC
62 East 300 North
Spanish Fork, UT 84660
Phone: 801-770-4203 (9-5 Mountain)
Fax: 801-770-4428
Email:

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)


Free 28 Day Trial
No Credit Card Required
Pricing
Starting at $4.95/month
Sign In
Welcome back!