"Medicare" & "Coding" Articles


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


Cross-A-Code Instructions in Find-A-Code

|

Cross-A-Code is a tool found in Find-A-Code which helps you to locate codes in other code sets that help you when submitting a claim.

Locating Periodontal Disease in ICD-10-CM

|

When coding a diagnosis for periodontal disease, keep in mind there are more options than just chronic or acute. To get started, look at chapter 11, Diseases of the digestive system (K00-K95). Looking at this section a little further, you can see this is where the oral cavity is coded ...

Medicare Improper Payment Report for Chiropractic (2019)

|

CMS audits claims on an annual basis to identify improper payments. These improper payments do not measure fraud. Rather, they estimate the share of payments that did not meet Medicare coverage, coding, and billing rules. In the most recent Improper Payment Report by specialty, chiropractic has the highest Part B improper payment ...

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 ...

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 ...

Are NCCI Edits and Modifiers 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 ...

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.

Understanding UCR Inpatient Fees used on DRGs

|


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 ...

Additional COVID-19 Testing Codes Announced

|

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

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 ...

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 ...

Changes in Medicare Advantage and Part D

|

The Centers for Medicare & Medicaid Services finalized several changes in Medicare Advantage and Part D on Friday.  The Trump administration has finalized several changes in Medicare Advantage (MA) and Part D in anticipation of bid submissions on June 1. The Centers for Medicare & Medicaid Services (CMS) released  Friday that includes ...

Where is the CCI Edit with Modifier 25 on E/M?

|

If you are not seeing a CCI edit when reporting an E/M code with a certain procedure, it may be that there is no edit. CMS does not have a CCI edit for every CPT code, however, there are still general coding rules that must be followed.  The use of Modifier 25 is one example ...

Packaging and Units for Billing Drugs

|

To determine the dosage, size, doses per package and how many billing units are in each package, refer to the NDC number. Take a look at the following J1071 - Injection, testosterone cypionate, 1mg For example; using NCD # 0009-0085-10 there are 10 doses of 100 mL (100 mg/mL = 1 mL and there are ...

Additional Telehealth Changes Announced by CMS

|

On April 30, 2020, CMS announced additional sweeping changes to meet the challenges of providing adequate healthcare during this pandemic. These changes expand the March 31st changes. The article covers some of the key changes. See the official announcement in the references below.

Special COVID Laboratory Specimen Coding Information

|

With all the new laboratory test codes that have been added due to the current public health emergency (PHE), there are a few additional guidelines CMS has released about collecting samples to perform the testing. Please keep in mind that these guidelines are by CMS and may or may not apply to other commercial payer policies.

New CPT® Codes Approved for COVID-19 Antibody Identification

|

On April 10, 2020, the American Medical Association approved and published a revision of code 86318 and added two new codes 86328 and 86769 for reporting Coronavirus [COVID-19] antibody testing.

CPT Coding Guidance on New Lab Code for COVID-19

|

According to the AMA, "The Addition of one Category I Pathology and Laboratory code (87635) for severe acute respiratory syndrome coronavirus 2 (SARS-2-CoV-2) (Coronavirus disease [COVID-19]) accepted at the March 2020 CPT Editorial Panel meeting. *Note that code 87635 will be a child code under parent code 87471. It is represented here ...

COVID-19 Chiropractic Resources

|

COVID-19 Chiropractic Resources contains current, updated information regarding COVID-19. Included are lists of webinars, articles, websites and links pertaining to the ongoing changes.

More Telehealth Changes Announced by CMS

|

On March 31, 2020, CMS announced further changes to their telehealth program in response to this unprecedented public health emergency (PHE). See this article for further information as well as references & links to CMS information

Medicare Part D Coverage Gap (Donut Hole) Closes in 2020

|

Overview of the Part D coverage gap, how it got closed, what the picture looks like for 2020, and long-term outlook.

"What is the ICD-10 code for...?" - Search Smarter With Find-A-Code Tools

|

Do you still find yourself searching the internet for an ICD10 code? Medical coders often type into their search engine, what is the ICD10 code for ... and a specific diagnosis code, to avoid repeatedly dragging out the incredibly large ICD10 codebook. Ironically, some of the most commonly searched ICD10 diagnoses include: ...

Understand the New Codes for Testing & Reporting the COVID-19 Coronavirus (SARS-CoV-2)

|

The current coronavirus pandemic refers to COVID-19, a novel or new type of coronavirus known as severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2). The first victim of the virus was identified in Wuhan, Hubei, China at the end of 2019. There is no immunization available to prevent it from spreading and ...

Coronavirus - What in the World is it and How is it Coded? 2020-02-20

|

On December 31, 2019, we learned of a deadly outbreak of an unknown virus, with an unknown cause. We have since learned the virus was identified in Wuhan, China as a novel coronavirus (2019-n-CoV). Until we have more information on the 2019-nCoV, persons with an underlying medical condition are considered high ...

Medicare Begins Covering Acupuncture Services

|

Medicare is changing their policy regarding coverage of acupuncture, but in order to provide these services, you must follow their rules.

A 2020 Radiology Coding Change You Need To Know

|

The radiology section of the 2020 CPT© has 1 new, 18 revised, and 14 deleted codes. Interestingly, six of the 14 deleted codes were specific to reporting single-photon computerized tomographic (SPECT) imaging services of the brain, heart, liver, bladder, and others. If your organization reports radiology services, it is...

Medicare Announces Coverage of Acupuncture Services

|

On January 21, 2020, a CMS Newsroom press-release read, This new announcement is both exciting and refreshing. Acupuncture, a key component of traditional Chinese medicine and most commonly used to treat pain, is now being officially recognized by Medicare and several other large payers as a covered, alternative treatment option for ...

Who Knew? There are Three Types of Add-On Codes

|

Using add-on codes with HCPCS/CPT is not as simple as 123! Although there are three different groups of add-on codes assigned by CMS, these are used to identify code edits. It is easy to see the add-on code with some codes; we can see the instructional notes and phrases such ...

Denials due to MUE Usage - This May be Why!

|

CMS assigns Medically Unlikely Edits (MUE's) for HCPCS/CPT codes, although not every code has an MUE. MUE edits are used to limit tests and treatments provided to a Medicare patient for a single date of service or for a single line item on a claim form. It is important to understand MUE's are ...

Changes to Portable X-Ray Requirements

|

On September 30, 2019, CMS published a final rule which made changes to portable x-ray services requirements as found in the law.

Hypertension & ICD-10

|

Hypertensive Diseases and ICD-10. Helps and examples for these codes.

Do ICD-10 Updates Have Your Heart Beating Irregularly? Check Out the New Atrial Fibrillation Codes

|

Atrial fibrillation (AF) is the most common type of abnormal heart rhythm (arrhythmia). It is caused by a disorder in the heart’s electrical system. AF is the result of abnormal contractions of the atria (upper two chambers of the heart) causing them to quiver and beat out of sync with ...

The New ICD-10-CM Code Updates Are Here — Are You Ready?

|

Chapter 1: Certain Infectious and Parasitic Diseases (A00-B99) A small revision in the description changed[STEC] to (STEC) for B96.21, B96.22, B96.23. Remember, in the instructional guidelines, ( ) parentheses enclose supplementary words not included in the description (or not) and [ ] brackets enclose synonyms, alternative wording, or explanatory phrases. Chapter 2: ...

CMS and HHS Tighten Enrollment Rules and Increase Penalties

|

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 ...

Are You Aware of Medicare Advantage Plans Timely Filing Rules?

|

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 ...

Understanding Payment Indicators

|

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 ...

How to Properly Report Prolonged Evaluation and Management Services

|

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 ...

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

|

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 ...

The Slippery Slope For CDI Specialists

|

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 ...

Q/A: How do I Bill Mobile Clinic Services?

|

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?

Q/A: What do I Need to Document for Periodic Adjustments on a Medicare Patient?

|

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 ...

Act Now on CMS Proposal to Cover Acupuncture for Chronic Low Back Pain

|

Now is the time to comment on a proposal to cover acupuncture for chronic low back pain. This comment period is the part of the HHS response to the opioid crisis. You only have until August 14th to officially comment.

Q/A: Do I Use 7th Character A for all Sprain/Strain Care Until MMI?

|

Question:  It is in regards to the Initial and Subsequent 7th digit (A and D) for sprains and strains. Recently, I have been told that I should continue with the A digit until the patient has reached Maximum Medical Improvement (MMI) and then switch over to the D place holder. Is ...

The Importance of Medical Necessity

|

ICD-10-CM codes represent the first line of defense when it comes to medical necessity. Correctly chosen diagnosis codes support the reason for the visit as well as the level of the E/M services provided. The issue of medical necessity is one of definitions and communication. What is obvious to the ...

Helping Others Understand How to Apply Incident to Guidelines

|

Over the past few months, I have worked with different organizations that have been misinterpreting the "incident to" guidelines and, in return, have been billing for services rendered by staff that are not qualified to perform the services per AMA and CPT. What I found within the variances is that ...

Extrapolation Policies Apply to RAD-V Audits

|

Risk Adjustment is a program that was implemented to identify and support Medicare beneficiaries with health conditions, illnesses, or injuries that put them at risk of death or organ system/bodily function failure. Through Risk Adjustment (RA), Medicare ensures their beneficiaries are being followed at least annually for any healthcare conditions ...

A United Approach

|

A United Approach As auditors, we all have a different perspective when evaluating documentation. It would be unreasonable to think that we all view things the same way. In my opinion, differing perspectives are what makes a great team because you can coalesce on a particular chart, work it through and ...

What Medical Necessity Tools Does Find-A-Code Offer?

|

Find-A-Code is a great resource for individuals working in all aspects of healthcare, from providers and ancillary staff to the attorneys and payers who assess and critique the documentation supporting the services performed. When recently asked what tools Find-A-Code has to help support medical necessity, our response was, "We provide many resources ...

How to Code Ophthalmologic Services Accurately

|

Have you ever tried to quickly recall the elements required to support a comprehensive ophthalmologic exam versus an intermediate one? Make coding decisions quickly by creating a cheat sheet containing vital information that allows you to quickly select the right code. According to Article A19881 which was published in 2004 and ...

Noting "Noncontributory" for Past Medical, Family, Social History - Is It Acceptable?

|

Is "noncontributory" really an unacceptable word to describe a patient whose family history doesn't have any bearing on the condition being evaluated and treated today?

Spotlight: QPro Blogs

|

Look for important tips and updates for the medical industry on the QPro Blog! The link to the blog is available from the Medical page under the Industries tab. Use the search bar to look up topics and specialties. View the blogs page here. ...

Electrical Stimulation and Electromagnetic Therapy Devices

|

Electrical Stimulation and Electromagnetic Therapy Devices can be used for pain, muscle atrophy, help spinal cord injuries, treat symptoms caused by other medical conditions and can be used in the treatment of wounds. This Regence BC/BS article lists codes and devices and gives guidance on coding from Medicare Advantage viewpoint.

Medicare Revises Their Appeals Process

|

On April 12, 2019, Medicare announced that there will be some changes to their appeals process effective June 13, 2019. According to the MLN Matters release (see References), the following policy revisions in the Medicare Claims Processing Manual (MCPM), Chapter 29 are taking place: The policy on use of electronic signatures Timing ...

What is Medical Necessity and How Does Documentation Support It?

|

We recently fielded the question, “What is medical necessity and how do I know if it's been met?" The AMA defines medical necessity as: It is important to understand that while the AMA provides general guidance on what they consider medically necessary services, these particular coding guidelines are generic and may be ...

Auditing Chiropractic Services

|

Chiropractic is unique from other types of health care and auditors need to be aware of the nuances of this field. Chiropractic has become the focus of more and more audits as doctors seem to struggle to create records that properly support the care provided to the patient throughout the entire episode.

Q/A: What’s Wrong with the Diagnoses on my Claim?

|

Question: I got a denial on my claim and it said the problem was with the diagnoses codes that I used. I used M54.15 and M79.2. I don’t understand why this is a problem.

Q/A: What do I do When a Medicare Patient Refuses to Sign an ABN?

|

Question: What do I do when a Medicare patient refuses to sign an ABN? Answer: That depends on whether the patient is still demanding to have/receive the service/supply. If they aren’t demanding the service, then there is no need to force the issue. Just make sure that you still have an ...

Prolonged Services

|

Prolonged Services I find in my own audit reviews that the prolonged service code set is often mistreated: they are avoided and not used even when the scenario supports them, or they get overused and improperly documented. Prolonged services are used in conjunction with all types of Evaluation and Management (E/M) ...

Pain Codes in ICD-10-CM

|

When coding with ICD-10-CM, pain codes can be found in different sections: The Body System affected or site-specific pain codes, such as Low Back Pain M54.5, can be found in Chapter 13. Diseases of the Musculoskeletal system (M00-M99). Other examples might be ocular pain H57.1, found in Chapter 7. Diseases of ...

Add on Codes for CPT (Appendix D)

|

For 2019, the following is a list of CPT add-on codes: 01953 19294 33225 37223 61864 76814 93325 97598 01968 19297 33257 37232 61868 76937 93352 97811 01969 20930 33258 37233 62148 76979 93462 97814 10004 20931 33259 37234 62160 76983 93463 99100 10006 20932 33367 37235 63035 77001 93464 99116 10008 20933 33368 37237 63043 77002 93563 99135 10010 20934 33369 37239 63044 77003 93564 99140 10012 20936 33419 37247 63048 77063 93565 99153 10036 20937 33508 37249 63057 77293 93566 99157 11001 20938 33517 37252 63066 78020 93567 99292 11008 20939 33518 37253 63076 78496 93568 99354 11045 20985 33519 38102 63078 78730 93571 99355 11046 22103 33521 38746 63082 81266 93572 99356 11047 22116 33522 38747 63086 81416 93592 99357 11103 22208 33523 38900 63088 81426 93609 99359 11105 22216 33530 43273 63091 81536 93613 99415 11107 22226 33572 43283 63103 82952 93621 99416 11201 22328 33768 43338 63295 86826 93622 99467 11732 22512 33866 43635 63308 87187 93623 99486 11922 22515 33884 44015 63621 87503 93655 99489 13102 22527 33924 44121 64462 87904 93657 99494 13122 22534 33929 44128 64480 88155 93662 99498 13133 22552 33987 44139 64484 88177 94645 99602 13153 22585 34709 44203 64491 88185 94729 99607 14302 22614 34711 44213 64492 88311 94781 0054T 15003 22632 34713 44701 64494 88314 95079 0055T 15005 22634 34714 44955 64495 88332 95873 0076T 15101 22840 34715 47001 64634 88334 95874 0095T 15111 22841 34716 47542 64636 88341 95885 0098T 15116 22842 34808 47543 64643 88350 95886 0163T 15121 22843 34812 47544 64645 88364 95887 0164T 15131 22844 34813 47550 64727 88369 95940 0165T 15136 22845 34820 48400 64778 88373 95941 0174T 15151 22846 34833 49326 64783 88388 95962 01953 15152 22847 34834 49327 64787 90461 95967 01968 15156 22848 35306 49412 64832 90472 95984 01969 15157 22853 35390 49435 64837 90474 96113 0205T 15201 22854 35400 49568 64859 90785 96121 0214T 15221 22858 35500 49905 64872 90833 96131 0215T 15241 22859 35572 50606 64874 90836 96133 0217T 15261 22868 35600 50705 64876 90838 96137 0218T 15272 22870 35681 50706 64901 90840 96139 0222T 15274 26125 35682 51797 64902 90863 96160 0229T 15276 26861 35683 52442 64913 91013 96161 0231T 15278 26863 35685 56606 65757 92547 96361 0290T 15777 27358 35686 57267 66990 92608 96366 0376T 15787 27692 35697 58110 67225 92618 96367 0396T 15847 29826 35700 58611 67320 92621 96368 0397T 16036 31627 36218 59525 67331 92627 96370 0399T 17003 31632 36227 60512 67332 92921 96371 0437T 17312 31633 36228 61316 67334 92925 96375 0439T 17314 31637 36248 61517 67335 92929 96376 0443T 17315 31649 36474 61611 67340 92934 96411 0450T 19001 31651 36476 61641 69990 92938 96415 0466T 19082 31654 36479 61642 74301 92944 96417 0471T 19084 32501 36483 61651 74713 92973 96423 0480T 19086 32506 36907 61781 75565 92974 96570 0482T 19126 32507 36908 61782 75774 92978 96571 0492T 19282 32667 36909 61783 76125 92979 96934 0496T 19284 32668 37185 61797 76802 92998 96935 0513T 19286 32674 37186 61799 76810 93320 96936 0514T 19288 33141 37222 61800 76812 93321 97546 0523T ...

Clearing Up Some Medicare Participation Misunderstandings

|

Even though we may think we truly understand what it means to be a participating provider, Medicare doesn’t quite work the way that other insurance plans do. Far too many providers do not understand the difference and get into hot water. To further complicate matters, the rules are different for ...

Spotlight: CPT to Revenue Codes Crosswalks

|

View CPT to Revenue Code Crosswalks with Cross-A-CodeFirst, enter your CPT code into the Comprehensive search bar. Once you click search, you should be taken to the code definition page. Scroll down to the Cross-A-Code bar and click to expand. Click the UB04 Revenue Codes bar to open the crosswalks....

The Impact of Medical Necessity on High Level E/M Services

|

I was recently asked the question, "Does 99233 require documentation of a past medical, family, and/or social history (PFSH)?"  The quick answer is, "it depends." Code 99233 has the following minimal component requirement: Subsequent inpatient E/M encounters can meet the code level requirement either by component scoring & medical necessity or time & medical necessity. ...

Type of Bill Code Structure (2018-08-30)

|

The UB-04 claim form (also known as CMS 1450) is the standard facility and residential claim form used to report health claims. The Type of Bill is reported in Block No. 4 of the UB04 claim form. Type of bill codes are four-digit codes that describe the type of bill a ...

Revised ABN Requirements Still Fuzzy

|

Although it has been quite some time since ChiroCode published an article about the revised instructions for non-participating providers  who use the ABN, there are still some outstanding questions about this change. So far, Medicare has not provided additional guidance about this question despite requests by us for clarification. Medicare now requires non-participating providers to include the ...

Q/A: Can you Help me Understand the New Medicare Insurance Cards?

|

As many of you are aware, CMS began issuing new Medicare identification cards last year which required the replacement of social security numbers with a new Medicare Beneficiary Identifier (MBI). All cards have now been mailed out and patient's should have the new cards when they come in. Currently, we are in the transition period until January 2020.

Understanding NCCI Edits

|

Medicare creates and maintains the National Correct Coding Initiative (NCCI) edits and NCCI Policy Manual, which identify code pair edits. When performed on the same patient, on the same day, and by the same provider, the secondary code is considered an integral part of the primary code, and payment for ...

Medicare Supplemental Policies (MediGap) and Extremity Adjustments

|

The nice thing about MediGap policies is that they pay for some of the healthcare costs that an original Medicare plan (Part B) does not cover. So when a patient has Medicare and a Medicare supplement (MediGap) and their condition is related to an extremity (a noncovered service), Medicare must ...

Q/A: What's the Difference Between Q5 and Q6 for a Substitute Provider?

|

It is important to understand that modifiers Q5 and Q6 are not interchangeable. So when do you use each of them?

Proposed Rule: Expanded Telemedicine Benefits for Medicare Advantage Beneficiaries

|

Telemedicine continues its rise, with new technologies allowing for better communication and access to more aspects of healthcare than ever before. Each year Medicare has made strides, albeit small strides, in their telemedicine coverage while commercial payers continue to make great strides, constantly improving and expanding telemedicine service offerings to ...

Coding Medicare Initial Preventive Physical Exams (IPPE)

|

The Medicare Initial Preventive Physical Exam (IPPE), also commonly referred to as the “Welcome to Medicare Physical”, may seem daunting to many, but when broken out to identify the requirements is fairly straightforward. Purpose An IPPE helps the Medicare beneficiary (the patient) get to know their healthcare provider at a time when they ...

Charging Missed Appointment Fees for Medicare Patients

|

Some providers mistakenly think that they cannot bill a missed appointment fee for Medicare beneficiaries. You can, but Medicare has specific rules that must be followed. These rules are outlined in the Medicare Claims Policy Manual, Chapter 1, Section 30.3.13. You must have an official “Missed Appointment Policy” which is ...

Clinical Staff vs. Healthcare Professional

|

State scope of practice laws and regulations will help determine who is considered Clinical staff and Other qualified Health Care professionals.  Physician or other qualified healthcare professionals:  Must have a State license, education training showing qualifications as well as facility privileges.  Examples of Qualified Healthcare professionals: (NOTE: this list is not all-inclusive, please refer to your payer ...

Q/A: Can I Bill a Review of X-Rays?

|

It is not unusual for a healthcare provider to review x-rays taken and professionally read by another entity. Questions arise regarding how to bill this second review. It is essential to keep in mind that the global (complete) service of taking an x-ray is composed of both a professional and ...

Attestations Teaching Physicians vs Split Shared Visits

|

Physicians often use the term "attestation" to refer to any kind of statement they insert into a progress note for an encounter involving work by a resident, non-physician practitioner (NPP), or scribe. However, for compliance and documentation purposes, "attestation" has a specific meaning and there are distinct requirements for what ...

Q/A Neonate Coding When Child is Transferred (2019/01/17)

|

Codapedia  Forum - Questions & Answers Q/A: Neonatologist was at the birth of a very critical child, she billed 99468 and then it was decided to transfer the child to another facility, she also billed 99291 and 99292 x 3. Her time was denied, how should she have billed for the initial ...

Empowering Medicare Beneficiaries

|

BLOG: CMS announced a NEWS release today making it easier to help Medicare Beneficiaries access cost and quality information. CMS announced,  "Today, the Centers for Medicare & Medicaid Services (CMS) launched a new app that gives consumers a modernized Medicare experience with direct access on a mobile device to some of ...

QPro - Medical Certifications

|

QPro (Qualified Professionals) is a member support system dedicated to enhancing coding and management through certification for healthcare coders and managers. Through increased knowledge of coding principles, changes in coding policies, and the experiences of fellow coders and managers in resolving office challenges, QPro members confidently code for maximum and ...

How to Report Co-Surgeons Using Modifier 62

|

Modifier 62 is appended to surgical claims to report the need for the skills of two surgeons (co-surgeons) to perform a procedure, with each surgeon performing a distinct part of the same procedure, during the same surgical session. An easy way to explain this is to visualize a patient requiring cervical fusion where ...

Home Oxygen Therapy

|

Home Oxygen Therapy Guidelines

Q/A: Is G8730 Still Required? Are G Codes Required at all?

|

G8730, when is it required. Many G codes are still active and are required for non-quality reporting.

CMS Finalizes Major Changes to ACO Program

|

Back in August of 2018, as part of the Medicare Shared Savings Program (Shared Savings Program), CMS proposed some sweeping changes for Accountable Care Organizations (ACOs). There has been some controversy over these changes which require ACOs to move to two-sided models. In this Final Rule which was scheduled to be published in the Federal Register ...

Are You Ready For the 2019 New Codes

|

Many articles have been published regarding the 2019 proposed Evaluation and Management coding changes, but hopefully you have taken the time to review those in detail and be ready for them. If not, here is a link to a Find-A-Code article written by Wyn Staheli (Director of Research) entitled, “Are You Ready ...

Welcome 2019 CPT Codes!

|

The AMA has released the New, Revised and Deleted CPT codes these are currently available on Find-A-Code. View the entire list of changes on the CODE tab and select CPT. Be sure to review all of the changes effective January 01, 2019.   168 New Codes 72   Deleted Code 51   Revised Codes Here are ...


older articles ↓



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:


article topics


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.