All Payers Articles and Resources

This page contains articles, resources/links and tips related to All Payers.

  • Articles:  24
  • Tips:  4
  • Resoures/Links:  0
  • Webinars:  0

Select the title to view a summary and link to the full article.

Dismal OIG Report on Telemedicine

|

Providers need to understand the rules for reporting telemedicine services. A recent OIG report shows that this is not the case. What problems are being found in documentation claims? As providers are expanding their telehealth offerings, now is the time to understand the potential pitfalls since disallowed amounts will be taken back.

Read the article →

New CPT® Codes Approved for COVID-19 Antibody Identification

|

On April 10, 2020, the American Medical Association approved and published a revision of code 86318 and added two new codes 86328 and 86769 for reporting Coronavirus [COVID-19] antibody testing.

Read the article →

CMS Temporarily Suspends Contract-Level RADV Audits

|

The Centers for Medicare and Medicaid Services (CMS) is suspending contract-level RADV audits, related to the payment year 2015 and will not initiate any new ones until after the public health emergency has ended. Any documentation already submitted will be reviewed as usual.

Read the article →

"What is the ICD-10 code for...?" - Search Smarter With Find-A-Code Tools

|

Do you still find yourself searching the internet for an ICD10 code? Medical coders often type into their search engine, what is the ICD10 code for ... and a specific diagnosis code, to avoid repeatedly dragging out the incredibly large ICD10 codebook. Ironically, some of the most commonly searched ICD10 diagnoses include: ...

Read the article →

Understand the New Codes for Testing & Reporting the COVID-19 Coronavirus (SARS-CoV-2)

|

The current coronavirus pandemic refers to COVID-19, a novel or new type of coronavirus known as severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2). The first victim of the virus was identified in Wuhan, Hubei, China at the end of 2019. There is no immunization available to prevent it from spreading and ...

Read the article →

A 2020 Radiology Coding Change You Need To Know

|

The radiology section of the 2020 CPT© has 1 new, 18 revised, and 14 deleted codes. Interestingly, six of the 14 deleted codes were specific to reporting single-photon computerized tomographic (SPECT) imaging services of the brain, heart, liver, bladder, and others. If your organization reports radiology services, it is...

Read the article →

VA- Reasonable Charges Rules, Notices, & Federal Register

|

Read the article →

Do ICD-10 Updates Have Your Heart Beating Irregularly? Check Out the New Atrial Fibrillation Codes

|

Atrial fibrillation (AF) is the most common type of abnormal heart rhythm (arrhythmia). It is caused by a disorder in the heart’s electrical system. AF is the result of abnormal contractions of the atria (upper two chambers of the heart) causing them to quiver and beat out of sync with ...

Read the article →

The New ICD-10-CM Code Updates Are Here — Are You Ready?

|

Chapter 1: Certain Infectious and Parasitic Diseases (A00-B99) A small revision in the description changed[STEC] to (STEC) for B96.21, B96.22, B96.23. Remember, in the instructional guidelines, ( ) parentheses enclose supplementary words not included in the description (or not) and [ ] brackets enclose synonyms, alternative wording, or explanatory phrases. Chapter 2: ...

Read the article →

Are You Aware of Medicare Advantage Plans Timely Filing Rules?

|

The Medicare Fee for Service (FFS) program (Traditional or Original Medicare) has a timely filing requirement; a clean claim for services rendered must be received within one year of the date of service or risk payment denial. As any company who has billed Medicare services can attest, the one-year timely filing ...

Read the article →

Extrapolation Policies Apply to RAD-V Audits

|

Risk Adjustment is a program that was implemented to identify and support Medicare beneficiaries with health conditions, illnesses, or injuries that put them at risk of death or organ system/bodily function failure. Through Risk Adjustment (RA), Medicare ensures their beneficiaries are being followed at least annually for any healthcare conditions ...

Read the article →

What Medical Necessity Tools Does Find-A-Code Offer?

|

Find-A-Code is a great resource for individuals working in all aspects of healthcare, from providers and ancillary staff to the attorneys and payers who assess and critique the documentation supporting the services performed. When recently asked what tools Find-A-Code has to help support medical necessity, our response was, "We provide many resources ...

Read the article →

Let's Talk High Risk E/M Services

|

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 American Medical Association and Medicare-published E/M Guidelines agree that a ...

Read the article →

What is Medical Necessity and How Does Documentation Support It?

|

We recently fielded the question, “What is medical necessity and how do I know if it's been met?" The AMA defines medical necessity as: It is important to understand that while the AMA provides general guidance on what they consider medically necessary services, these particular coding guidelines are generic and may be ...

Read the article →

The Impact of Medical Necessity on High Level E/M Services

|

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 can meet the code level requirement either by component scoring & medical necessity or time & medical necessity. ...

Read the article →

How to Report Imaging (X-Rays) of the Thumb

|

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 ...

Read the article →

Understanding NCCI Edits

|

Medicare creates and maintains the National Correct Coding Initiative (NCCI) edits and NCCI Policy Manual, which identify code pair edits. When performed on the same patient, on the same day, and by the same provider, the secondary code is considered an integral part of the primary code, and payment for ...

Read the article →

Proposed Rule: Expanded Telemedicine Benefits for Medicare Advantage Beneficiaries

|

Telemedicine continues its rise, with new technologies allowing for better communication and access to more aspects of healthcare than ever before. Each year Medicare has made strides, albeit small strides, in their telemedicine coverage while commercial payers continue to make great strides, constantly improving and expanding telemedicine service offerings to ...

Read the article →

Are You Protecting Your Dental Practice From Fraud?

|

With the expansion of dental coverage through Medicaid and Medicare Advantage plans, an ever-increasing number of dental claims have come under scrutiny for fraud. One such payer, Aetna, is actively pursuing dental fraud by employing their special investigative units (SIUs) to identify and investigate providers who demonstrate unusual coding and ...

Read the article →

Nine New Codes for Fine Needle Aspirations (FNA) in 2019

|

If your practice performs a lot of fine needle aspirations (FNA), you probably have the code options memorized (10021 without image guidance and 10022 with image guidance). However, the 2019 CPT codes now include nine (9) new FNA codes (10004-10012), one deleted FNA code (10022) and one revised FNA code ...

Read the article →

Show older articles ↓


There are more articles. View all articles...

View articles for the current payer by subtopic:



Access to this feature is available in the following products:
  • HCC Coder
  • Find-A-Code Professional
  • Find-A-Code Facility Base




   (There are no webinars at this time, please check back later.)


   (No resources at this time, please check back later.)

Commercial Payer Policies

  • Commercial Payer Policies from over 85 commercial payers
  • Instantly search through over 34,000 payer policies for codes or keywords
  • Code information pages show all relevant policies for the code
  • Save and annotate policies
  • Instant access to the last 30 policies you viewed

Available add-on with Find-A-Code™ subscription

Click here to learn more!



suggest a resource

If you know of a resource that should be included here (links, data, etc.) please contact us.

free demo
request yours today
pricing
for any budget
sign IN
welcome back!

Thank you for choosing Find-A-Code, please Sign In to remove ads.