March 21, 2019 - By Aimee Wilcox, CPMA, CCS-P, CMHP, CST, MA, MT
If you've ever taken piano lessons, you know that the thumb is considered the first finger of the hand. Anatomically, it is also referred to as the first phalanx (finger). However, when you are coding an x-ray of the thumb, images are captured of the thumb, hand, wrist, and all of the joints in... Read More
March 21, 2019 - By Aimee Wilcox, CPMA, CCS-P, CMHP, CST, MA, MT
Have you ever assigned a high-complexity E/M code (e.g., 99205, 99215, 99223, 99233, 99245, etc.) and wondered if it would stand up to further scrutiny? Well, let’s take a closer look at the requirements for reporting high-level E/M services.
Both the Amer... Read More
March 21, 2019 - By Brandon Dee Leavitt QCC, CMCS, CPC, EMT
For hearing impairment, Medicare is firm in its stance on when it will and will not cover hearing correction. In the PUB 100-02 Medicare Benefit Policy Manual, Chapter 16, Medicare cites the Social Security Act by explaining:
"..."hearing aids or examination for the purpose of prescribing,... Read More
March 21, 2019 - By Aimee Wilcox, CPMA, CCS-P, CMHP, CST, MA, MT
In 2018, Medicare announced their plans for revamping the Evaluation and Management coding structure and was met with a rapid response from the medical community, including the AMA and many other organizations. As a result, the Medicare changes implemented in 2019 were mostly document... Read More
March 21, 2019 - By Aimee Wilcox, CPMA, CCS-P, CMHP, CST, MA, MT
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 c... Read More
Providers need to ensure that they are reporting radiology dates of service the way the payer has requested. Unlike many other professional services which only have one date of service (DOS), radiology services can span multiple dates.
There seems to be some disagreement between professional organi... Read More
February 28, 2019 - By Aimee Wilcox, CPMA, CCS-P, CMHP, CST, MA, MT
Medicare creates and maintains the National Correct Coding Initiative (NCCI) edits and policy manual, which identify code pairs considered integral to one another or bundled. An NCCI code pairs consists of two codes representing procedures that when performed during the same operative sess... Read More
February 13, 2019 - By Aimee Wilcox, CPMA, CCS-P, CMHP, CST, MA, MT
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... Read More
Have you ever had a knot in your back where the muscles simply cannot relax? Those knots are referred to as trigger points and they can be very painful. As a matter of fact, a trigger point (TP) in one area can cause surrounding muscles to tighten or spasm, increasing pain and discomfort for th... Read More
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