General Surgery Coding Alert - 2016 Issue 20
Part B Revenue Booster: Turn Around These 5 Basic Blunders to Improve Your Cash flow
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Article Overview
This article discusses broad revenue-cycle and coding issues that can affect Part B claims performance, including documentation alignment, ICD-10 updates, modifier use, staffing qualifications, and ongoing training and auditing. It is aimed at practices, coders, billers, and administrators who want a general understanding of common workflow and compliance concerns that can affect reimbursement and claims accuracy.
Why This Topic Matters
The article helps readers identify high-level operational and coding areas that can contribute to claim denials, payment reversals, and compliance problems. It is relevant to organizations seeking to strengthen documentation, staff training, and coding processes without diving into specialty-specific guidance.
Article Sections
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Stay Abreast of the New ICD-10 Changes
Discusses the importance of keeping current with ICD-10 updates and maintaining access to timely coding resources. It also addresses the broader impact of change management on practice operations.
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Make Sure Your Notes and Your Codes Match
Focuses on documentation alignment, medical necessity, and the role of coding tools and software in supporting claim accuracy. The section also references Medicare-related compliance concepts and improper payment concerns.
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Watch Your Modifiers
Covers modifier-related billing issues and the general risks associated with incorrect application. It also mentions an OIG-reviewed hospital example and the need for education and reference materials.
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Hire Certified Coders and Billers
Addresses staffing qualifications, certification, and the general knowledge expected of coders and billers. It also notes the relevance of payer requirements, reimbursement, and Medicare Part B transparency initiatives.
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Train, Update, Audit
Reviews ongoing training, technology support, and auditing as part of a broader compliance and quality-improvement program. The section emphasizes maintaining current processes and checking for errors over time.
What You Will Learn
- Why staying current with ICD-10 updates matters for practice operations
- How documentation and coding alignment affect claim accuracy
- Why modifier use is a common area of billing risk
- What qualifications are emphasized for coders and billers
- How training, technology, and audits support compliance and revenue integrity
Who Should Read This
- Medical coders
- Medical billers
- Practice managers
- Healthcare administrators
- Compliance staff
- Revenue cycle staff
Codes Discussed
Modifiers Discussed
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