Find-A-Code Focus Newsletter

2016 March Items

Are you ready for the value based payment model?

March 28, 2016 - By Codapedia Editor - Victoria
By: Victoria (Tue, Mar/15/2016)  Healthcare professionals are being forced to move out of their comfort zones. Sweeping changes are being made to change the way healthcare is provided and paid for. 40% of in-network payments are tied to value. And the traditional fee for service model is expe... Read More

Modifiers in Postoperative Periods

March 28, 2016 - By Allison Singer, CPC, CPMA
Introduction Documenting the events of a patient visit is not always the simplest and most straightforward of processes. Many variables affect which information must be included in order to report a procedure or service accurately. Global periods are one of those variables. A global period is the a... Read More

Added Thoughts on Medical Necessity & Determining Appropriate Levels of Care

March 23, 2016 - By Stephen R. Levinson, M.D., CHCA ASA, LLC
February’s Find-A-Code Newsletter provided a superb summary of the importance of Medical Necessity in determining the appropriate level of care warranted during a given Evaluation and Management service. The author also accurately identified the “Nature of the Presenting Problem(s)&rdquo... Read More

New Addictions Bill has Bipartisan Support

March 21, 2016 - By Wyn Staheli
Some may be surprised to learn that last year overdoses from heroin, prescription drugs, and opioid pain relievers surpassed car accidents as the leading cause of injury-related death in America, according to the Centers for Disease Control.  This problem is placing a strain on an already... Read More

ICD-10-CM: Heart Failure

March 21, 2016 - By Bonnie Schreck
Congestive heart failure (CHF) is a common heart condition that exists in many patients. In ICD-9-CM coding, this was reported with code 428.0. In ICD-10-CM, if only CHF or congestive heart failure is documented, it would be reported with I50.9 Heart failure, and would not reflect the... Read More

ICD-10-CM updates announced! Well, sort of.

March 16, 2016
Who is in charge of these updates? March 9-10, 2016 the ICD-9-CM Coordination and Maintenance Committee met to discuss changes to ICD-10-CM, which begin October 1, 2016 at the earliest.  A representative from the National Center for Health Statistics (NCHS - part of the CDC) and one... Read More

Usability: What EHR Vendors Can Learn from the Gaming Industry

March 10, 2016 - By Alex Tate, CureMD
As an industry, healthcare can definitely learn a thing or two from the finance and retail sectors as far as keeping costs low while providing the highest quality services. When it comes to electronic health records in particular, there is yet another industry that vendors can learn from,&... Read More

ABN's, Third Party Payers, and Cash Pay

March 08, 2016
Medicare no longer wants providers to use ABN's for anyone other than CMS. Therefore, if contracted under commercial payers and 3rd party payers, you may need to contact the payer for a pre-service organization determination regarding coverage. This must be done before the provider can&nbs... Read More

Medicare Three Day Payment Window

March 07, 2016 - By Bonnie Schreck
In 2010, Medicare's policy for payment of outpatient services provided on either the date of a beneficiary's admission or during the three calendar days immediately preceding the date of a beneficiary's inpatient admission to a “subsection (d) hospital” subject to the inpatient... Read More

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