Outpatient Facility Coding Alert - 2015 Issue 5
Industry Notes: ICD-10 Still on Track for October, Despite Congressional Hearing
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Article Overview
This article collects several Medicare and coding industry updates relevant to coders, billing staff, and compliance teams. It discusses congressional attention to ICD-10 implementation timing, a MAC reminder about differentiating preventive medicine visits from the initial preventive physical exam, a policy update involving modifier 51, and payer guidance on documenting drug therapy monitoring in E/M risk assessment. The piece is useful for readers tracking current CMS and MAC educational guidance and procedural billing changes.
Why This Topic Matters
The article helps coding and billing professionals stay current on administrative and documentation topics that affect Medicare claims and evaluation and management reporting. It is relevant to teams monitoring implementation news, preventive service distinctions, modifier policy, and medical record support for higher-risk E/M scenarios.
Article Sections
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ICD-10 implementation hearing
Coverage of federal discussion about the ICD-10 transition timeline and related healthcare stakeholder input.
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Differentiate Preventive Medicine Visit From IPPE
Guidance from a Medicare contractor on distinguishing two preventive service categories and their general coverage context.
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This MAC Updates Its Modifier 51 Rules — Reminding You NOT to Use It
A contractor policy update addressing reporting practices for a commonly used procedure modifier.
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Don’t Take ‘Credit’ For Toxic Drug Management If You Aren’t Monitoring It
Documentation guidance for evaluation and management risk scoring tied to ongoing medication monitoring.
What You Will Learn
- Current industry discussion around ICD-10 implementation timing
- How Medicare contractor guidance distinguishes preventive service types
- What recent contractor messaging says about modifier reporting practices
- What documentation is discussed for drug therapy monitoring in E/M risk assessment
Who Should Read This
- Medical coders
- Billing specialists
- Compliance professionals
- Practice managers
- Revenue cycle staff
Codes Discussed
Code Ranges Discussed
Modifiers Discussed
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