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March 16th, 2021
ICD-10-CM 2021 Codes for your Specialty
Published March 16th, 2021|
14. Diseases of the genitourinary system (N00-N99) Code: Description:N00.A Acute nephritic syndrome with C3 glomerulonephritisN01.A Rapidly progressive nephritic syndrome with C3 glomerulonephritisN02.A Recurrent and persistent hematuria with C3 glomerulonephritisN03.A ...
August 10th, 2020
Coding Injections for Pain Management
Published August 10th, 2020|
Coding for pain management can get confusing. How many injections, the location, and when to use a modifier are all common questions. This article will cover some of the most common injections used in pain management. Trigger Point Injections Trigger point injections are reported by how many muscles are treated using an ...
August 5th, 2020
Coding with PCS When There is No Code
Published August 5th, 2020|
ICD-10-PCS covers ALMOST everything! But not quite! What if a body system does not contain a body part for toes or fingers? What about an elbow? When it does not cover what you are looking for, where do you turn? To the guidelines, of course! There are ICD-10-PCS guidelines just as ...
July 20th, 2020
New Grouper Added for Skilled Nursing
Published July 20th, 2020|
The additional grouper for Skilled Nursing, sometimes referred to as (PDPM), is used for classifying SNF patients in a covered Part A stay. This grouper is included with our Home Health Grouper. Current groupers/calculators include: Home Health PDGM (Patient-Driven Grouping Model) Skilled Nursing Facility PDPM (Patient-Driven Payment Model) What is it? According to CMS, In ...
July 14th, 2020
Are NCCI Edits and Modifiers Just for Medicare?
Published July 14th, 2020|
The National Correct Coding Initiative (NCCI) edits were developed by CMS to help promote proper coding and control improper coding that leads to incorrect payments with part B claims. It is important to understand that NCCI edits do not include every possible code combination or every type of un-bundling combination. With that ...
July 1st, 2020
Understanding UCR Inpatient Fees used on DRGs
Published July 1st, 2020|
June 15th, 2020
Outpatient Facility Pricing
Published June 15th, 2020|
Our newest feature launch offers UCR pricing for Outpatient Facility. We recently released pricing information based on databases of insurance claims from private-sector health care providers.Usual, customary, and reasonable charges (UCR) are medical fees used when there are no contractual pricing agreements and are used by certain healthcare plans and third-party payers to generate ...
April 15th, 2020
New CPT® Codes Approved for COVID-19 Antibody Identification
Published April 15th, 2020|
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.
March 31st, 2020
CMS-Coverage for Therapeutic Shoes for Individuals with Diabetes
Published March 31st, 2020|
Therapeutic shoes and inserts can play a vital role in a diabetic patient's health. Medicare may cover one pair every year and three pairs of custom inserts each calendar year if the patient qualifies and everything is handled correctly. Medicare Benefit Policy Manual explains what is needed for a person with diabetes to ...
March 5th, 2020
Who Qualifies for Chronic Care Management Services
Published March 5th, 2020|
Per MLN Chronic Care Management Services, the following patients are eligible: "Patients with multiple (two or more) chronic conditions expected to last at least 12 months or until the death of the patient, and that place the patient at significant risk of death, acute exacerbation/decompensation, or functional decline, are eligible for CCM services." Examples of chronic conditions ...
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2020 Pain Management ICD-10-CM Coding Book2020 Pain Management Reimbursement GuideAbout ODGAdvanced Beneficiary Notice of Noncoverage (ABN) Form Instructions ToolAmerican Nurses Association, IncBilateral Surgeries: Claim SubmissionCMS- Program of All-Inclusive Care for the Elderly -PACE AuditsCommonly Used Medicare Modifiers - GA, GX, GY, GZCompliance Program Guidance for Home Health AgenciesCompliance Program Guidance for Nursing FacilitiesDME Billing guideanceHospice - Medicare Claims Processing ManualHospice Medicare Billing Codes SheetMedicare Coverage for Skilled NursingMedicare Part A for Skilled NursingMedicare Part B Clinical Laboratory Fee ScheduleMLN - Billing and Payment Policies for Negative Pressure Wound Therapy (NPWT) Using a Disposable DeviceNoridian Diabetes PoliciesNoridian Nonphysician Practitioner (NPP) PoliciesNoridian Surgery PoliciesNoridian: Allowed Amount ReductionsPhysician Assistant (PA) Resources NoridianQ&A on Skilled Nursing Facility Consolidated BillingRural Skilled Nursing Facility Prospective Payment SystemSkilled Nursing Facility Best Practice GuidelinesSkilled Nursing Facility Consolidated BillingSkilled Nursing Facility Education and TrainingSkilled Nursing Facility Federal RegulationsSNF Billing ReferenceSNF Inpatient Part A Billing and SNF Consolidated Billing - Medicare Claims processing ManualSummary of the HIPAA Privacy Rule by HHSSupplemental Compliance Program Guide for Nursing Facilities
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