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Find-A-Code Focus Newsletter

2015 November Articles


Using 6 Characters for a 7 Character Code

November 30, 2015 - By Chris Woolstenhulme, CMRS
Don't do that!  The 7th character must always be the 7th character in the data field. If a code requires a 7th character and there is only 6 characters, a placeholder "X" must be used to fill in the empty characters.  Without the place holder, the code is considered invalid... Read More

Burnout and Emergency Medicine

November 30, 2015 - By Chris Woolstenhulme, CMRS
When it comes to Burnout, Emergency Medicine is hit the Hardest according to MedPage Today. The results come from a survey of burnout among U.S. Physicians. The mean average on those reporting burnout was 45.8%. The emergency physicians were certainly reporting higher burnout at more than 60%.... Read More

Be Proactive - Check Your Claim Status

November 30, 2015 - By Wyn Staheli
We've been using ICD-10-CM for a few weeks now. If you haven't already started getting EOBs from your payers, get proactive and start checking claim status on your own. You may have been coding correctly to begin with, but there can be some hiccups between claim submission and adjudication. For exam... Read More

You do not need to change or rewrite your original orders

November 25, 2015 - By CMS.gov
CMS wants to remind you not to change or rewrite your original orders for any service or product due to the change of code sets from ICD-9-CM to ICD-10-CM. For any type of product or service prior to October 1, 2015, do not change the order, even if it will be a continued service with dates spannin... Read More

CMS Extends Deadline for Physician Quality Reporting System (PQRS) Informal Review Process

November 24, 2015
CMS is extending the 2014 Informal Review period. Individual eligible professionals (EPs), Comprehensive Primary Care (CPC) practice sites, PQRS group practices, and Accountable Care Organizations (ACOs) that believe they have been incorrectly assessed the 2016 PQRS negative payment adjustment&nbs... Read More

CMS Extends 2016 Value Modifier Informal Review Deadline to December 16, 2015

November 24, 2015
The informal review period for the 2016 Value Modifier is open now through December 16, 2015. All requests must be submitted by 11:59 p.m. Eastern Time on December 16, 2015. The informal review process allows groups (as identified by their taxpayer identification number) wit... Read More

ICD-10 Transition: Clarifications about NCDs and LCDs

November 23, 2015
All Medicare national and local coverage policies are translated for ICD-10, and to receive payment, providers must bill using ICD-10 codes for services rendered on or after October 1, 2015. Check the National Coverage Determination (NCD) and Local Coverage Determination (LCD) policies in the M... Read More

How to Request a PQRS Informal Review

November 23, 2015 - By Brandy Brimhall CPC CMCO CPCO CCCPC CPMA
As you know, the PQRS (Physician Quality Reporting System) includes the reporting of particular G codes to communicate with Medicare, details of the Functional Outcome Assessment and Pain Assessment and Follow-Up measures. These measures must be completed on at least 50% of an eligible professional'... Read More

DMEPOS Product search

November 23, 2015
Finding the correct HCPCs code for Durable Medical Products and Supplies just got easier! Announcing  DMEPOS Product Search Find-A-Code gives you the capability to search for model and product numbers to assist in your search for the correct DME HCPCs codes.  Since this is for HCPCS code... Read More

HCC Risk Calculator added to Find-A-Code

November 22, 2015
Find-A-Code is excited to announce the release of a new tool! Check out our new HCC Risk Calculator   > Home > Code Sets.  It is located under the coding Tools section then Groupers & Calculators.  The tool is currently in Beta testing, we are looking for feedback, ideas an... Read More

Visit the CMS Website to Review the New Public Health Reporting FAQs

November 18, 2015
On October 6, CMS released the final rule for the Medicare and Medicaid Electronic Health Record (EHR) Incentive Programs. To support provider participation in 2015, CMS has released two additional FAQs in response to inquiries about the public health reporting objective in 2015. FAQ 13409Question:... Read More

NCCI FOR MEDICAL BILLERS

November 04, 2015
NCCI FOR MEDICAL BILLERS National Correct Coding Initiatives (NCCI) is a tool that coders can use when the provider has two CPT codes that are being billed to the insurance company for the same visit. As an example, Steve has chest pain. He visits his doctor who doesn't know if the chest pain is rel... Read More

DSM FAQ

November 03, 2015
The Diagnostic and Statistical Manual for Mental Disorders (DSM) is the standard classification of mental disorders used by mental health professionals in the United States. It is generally accepted as the authoritative guide for the diagnosis of mental disorders. This FAQ article was created to add... Read More

AMBA and Other Resources

November 03, 2015
The AMBA is the largest association in the nation that provides education, resources and credentials for independent, third party medical billers and doctor's office billers. The AMBA provides their services to medical billers that work from their home, office, or in physician offices. Billers can b... Read More

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