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Billing for Incontinence and Urinary Products

by  Christine Woolstenhulme, QMC QCC CMCS CPC CMRS

We all understand anything covered under health insurance must be medically necessary. In other words, it must be essential in treating and managing a patient's condition or to evaluate, diagnose, or treat an illness, injury, disease, or its symptoms. In this article, we will address catheters, urological supplies, and disposable ...

2023 ICD-10-CM Code Changes

by  Christine Woolstenhulme, QMC QCC CMCS CPC CMRS

In 2022 there were 159 new codes; the 2023 ICD-10-CM code update includes 1,176 new, 28 revised, and 287 deleted codes, a substantial change from last year. The 2023 ICD-10-CM codes are to be used for discharges from October 1, 2022 through September 30, 2023, and for patient encounters from ...

ICD-10-CM 2023 Code Changes for Chiropractic

by  Wyn Staheli, Director of Content - innoviHealth

There were several changes to the ICD-10-CM codeset for 2023 which went into effect October 1, 2023 and could impact chiropractic. At the time of publication, it was unknown how payers would respond to these changes. This article only discusses some of the changes to the ICD-10-CM codes. Changes to procedure codes such as “Prolonged Services” for office E/M visits are included in the 2023 ChiroCode DeskBook.

Emergency Department - APC Reimbursement Method

by  Christine Woolstenhulme, QMC QCC CMCS CPC CMRS

CMS pays emergency department visits through a payment method using Ambulatory Payment Classifications (APCs). Most payers also use the APC reimbursement system; however, there may be some differences in payer policies (always review your specific payer policy). APCs are the primary type of payment made under the OPPS, comprising groupings ...

CMS says Less Paperwork for DME Suppliers after Jan 2023!

by  Christine Woolstenhulme, QMC QCC CMCS CPC CMRS

Attention providers, suppliers, billers, and vendors who bill Durable Medical Equipment (DME) to Medicare!  Currently, a supplier receives a signed Certificate of Medical Necessity (CMN) from the treating physician or creates and signs a DME Information Form (DIFs); these are required to be sent with the claim. However, this is about ...

Billing and Documenting for Therapeutic Exercises versus Therapeutic Activities

by  Evan M. Gwilliam, DC MBA CPC CCPC CPC-I QCC MCS-P CPMA CMHP AAPC Fellow

Chiropractors treat, among other things, issues with the musculoskeletal system. Active therapeutic procedures are accepted as effective ways to treat many common conditions and therefore can be billed and generate revenue for a clinic. Two common CPT codes that might be used in a chiropractic setting include:

E/M Changes Coming Our Way in 2023!

by  Christine Woolstenhulme, QMC QCC CMCS CPC CMRS

Changes are one thing we can count on being consistent; even though this is one we have been anticipating, it is time to prepare, and we will have some work to do. The AMA released the new 2023 E/M Guidelines early to help us prepare for the change effective January ...

$636 Million in Overpayments Made by Medicare to Providers for Neurostimulators

by  Christine Woolstenhulme, QMC QCC CMCS CPC CMRS

According to the OIG "MEDICARE OVERPAID MORE THAN $636 MILLION FOR NEUROSTIMULATOR IMPLANTATION SURGERIES." So often we think if we get paid, we must be doing it right, well this is not always the case. You may get paid and then have to return the funds if billed incorrectly or a step ...

Coding for a Performance of an X-ray Service vs. Counting the Work as a Part of MDM

by  Stephanie Allard, CPC CEMA RHIT

When x-rays are audited on the same date as an E/M encounter we have one of three decisions to make about the work that went into the radiological exam when the practice owns x-ray equipment and does their own interpretations internally. First, we must determine whether the x-ray was...

Medicare Auditors Caught Double-Dipping

by  Edward Roche, PhD JD

Overlapping extrapolations require providers to pay twice. Some Medicare auditors have been caught “double-dipping,” the practice of sampling and extrapolating against the same set of claims. This is like getting two traffic tickets for a single instance of running a red light. This seedy practice doubles the amount...

2022-03-10-MLNC - COVID-19 Monoclonal Antibodies: Revised Emergency Use Authorization for EVUSHELD

by  CMS - MLNConnects

News - COVID-19 Monoclonal Antibodies: Revised Emergency Use Authorization for EVUSHELD - Program for Evaluating Payment Patterns Electronic Reports for Short-term Acute Care Hospitals - Quality Payment Program: 2020 Performance Information on Care Compare - Skilled Nursing Facilities: Submit Technical Expert Panel Nominations by March 16 ...

Cybersecurity & Ransomware Warnings

by  Wyn Staheli, Director of Content - innoviHealth

Although HIPAA Security protocols have been in effect for some time, as technology advances, if we are not diligent, gaps can be left available for intruders. On top of that, on February 23, 2022, the American Hospital Association issued a cybersecurity advisory. They stated, “there is concern that Russia may retaliate against the U.S. and allied nations with disruptive cyberattacks.”

Changes in RPM for 2021! Now, Wait for it... New RTM Codes for 2022

by  Christine Woolstenhulme, QMC QCC CMCS CPC CMRS

Remote physiologic monitoring and clinical data monitoring is a relatively new concept thriving and growing as an essential component for telehealth services. According to global consumer trends, a company called Dynata reported, "Among the 39% of people who consulted a healthcare professional, two-thirds used telemedicine, many of them for the first time ...

Understanding ASCs and APCs: Indicators and Place of Service

by  Christine Woolstenhulme, QMC QCC CMCS CPC CMRS

The decision regarding the most appropriate care setting for a given surgical procedure is determined by the physician based on the patient's individual clinical needs and preferences. Of course, there is a difference in reimbursement, and the billing depends on where the procedure took place, such as an office setting, inpatient ...

Is Your Organization Ready to Deal with Provider Relief Fund (PRF) Audit Contractors?

by  Aimee L. Wilcox, CPMA CCS-P CST MA MT

Audits are currently underway to verify the monies distributed through the CARES Act were warranted and properly used by those organizations that received them. The federal government has contracted with financial institutions such as KPMG and PricewaterhouseCoopers, among others, to perform these audits referred to as Provider Relief Fund (PRF) audit contractors, funded with monies from the very same program. There were four phases of funding disbursements with phase 1 audits beginning in September. How ready are you to be audited?

Five Major ICD-10-CM Changes That Can Effect Your Organization

by  Aimee L. Wilcox, CPMA CCS-P CST MA MT

Have you had a chance to review the new ICD-10-CM codes for FY 2022? Did you know that many payers do not want to see unspecified codes when there is a possibility for better data? How adept are you at assigning and sequencing COVID-19 codes? Take a minute to review 5 of the major changes to the FY2022 ICD-10-CM code updates and claim your chance to watch our most recent webinar where we review the newest code updates.

ICD-10-CM Cracks Down on the Use of "Unspecified" in the 2021 Official Guidelines

by  Aimee L. Wilcox, CPMA CCS-P CST MA MT

We always knew there would come a day when payers would look down on an "unspecified" diagnosis code and possibly even deny it or delay payment until a review of the record could be performed. ICD-10-CM was adopted by the U.S. for data analytics, which cannot be accurate if unspecified codes are reported when the documentation verifies greater specificity. Join us for a look at the many guideline changes to ICD-10-CM, a review of the newest code changes and suggestions on documentation improvement to elevate coding protocols.

Watch out for New ICD-10-CM Codes

by  Wyn Staheli, Director of Content - innoviHealth

New ICD Codes for: Low Back Pain, Cervicogenic Headache, Non-Radiographic Axial Spondyloarthritis (nr-axSpA), and Social Determinations of Health (SDOH). These codes became effective on October 1, 2021.

Injection Services

by  Christine Woolstenhulme, QMC QCC CMCS CPC CMRS

Injection Service Codes Injection service codes, are reported under administration of vaccines/toxoids, using 96372, 90460, 90461, 90471, 90472, 0001A, 0002A, 0003A, 0011A, 0012A, 0021A, 0022A, 0031A, 0041A, and 0042A. Other injections services include: Non-antineoplastic hormonal therapy injections – 96372 Anti-neoplastic nonhormonal injection therapy 96401 Anti-neoplastic hormonal injection therapy- 96402 Allergen immunotherapy - 95115-95117 According to CMS, do ...

Understanding How Place of Service Codes Work

by  Christine Woolstenhulme, QMC QCC CMCS CPC CMRS

The Place of service (POS) codes are used by CMS, Medicaid, and other private insurance to indicate where medically related items and services are sold or dispensed for a patient. POS codes are used for professional billing and are required to be reported on each claim submitted on a CMS-1500 ...
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Select the title to see a summary and a link to the full webinar information.  some webinars require a subscription to view.

Medicare and the ABN for Chiropractic 

by  Evan M. Gwilliam, DC MBA CPC CCPC CPC-I QCC MCS-P CPMA CMHP AAPC Fellow

What do Chiropractors Need to do to Comply with the No Surprises Act? 

by  Evan M. Gwilliam, DC MBA CPC CCPC CPC-I QCC MCS-P CPMA CMHP AAPC Fellow

Medicare Audit, Do-it-yourself 

by  Evan M. Gwilliam, DC MBA CPC CCPC CPC-I QCC MCS-P CPMA CMHP AAPC Fellow

Chiropractic Documentation: The Subjective Element 

by  Ron Short, DC MCS-P CPC

Chiropractic Documentation: The S.O.A.P. Format and Additional Information 

by  Ron Short, DC MCS-P CPC

Chiropractic Manipulative Treatment: Coding and Documentation 

by  Evan M. Gwilliam, DC MBA CPC CCPC CPC-I QCC MCS-P CPMA CMHP AAPC Fellow

Chiropractic Treatment Paradigm 2021 

by  Ron Short, DC MCS-P CPC

Chiropractic Treatment Paradigm 2021 

by  Ron Short, DC MCS-P CPC

Strategies for Improving Cash Flow and Collections - Starting Now 

by  Brandy Brimhall, CPC CMCO CPCO CCCPC CPMA QCC

Rock Solid Care Plans 

by  Evan M. Gwilliam, DC MBA CPC CCPC CPC-I QCC MCS-P CPMA CMHP AAPC Fellow

Don't ever let anyone challenge your care plans ever again. If you can know what the regulators are looking for while still being free to deliver the care you deem to be best for your patient, then you win. And your patient wins. Join Dr. Gwilliam, certified professional medical auditor, and all around nice guy, as he guides you to the steps to create rock solid care plans that will stand up to third party scrutiny.

Proving Medical Necessity and Functional Improvement 

by  Ron Short, DC MCS-P CPC

Medicare is required by law to pay for care that is medically necessary. Medicare considers functional improvement to be the primary indicator of medical necessity for chiropractic care. It is up to you, the doctor, to prove functional improvement and medical necessity with your documentation. Dr. Short will show you how to use common practice tools to document functional improvement, medical necessity and maximum medical improvement.

Inappropriate Payments Made to Chiropractors – An OIG Review 

by  Evan M. Gwilliam, DC MBA CPC CCPC CPC-I QCC MCS-P CPMA CMHP AAPC Fellow

In this webinar, Dr. Gwilliam will take you on a fun filled journey through all of the reports created by the Office of the Inspector General based on their reviews of chiropractors. If you can understand what they see, and what advice they give Medicare when dealing with chiropractors, then you will be better prepared to not become their next target. This webinar may feel a little frightening with hundreds of thousands of dollars paid back to CMS, but, by the end, you will know exactly what to do and what not to do.

ICD-10-CM Changes Effective October 1, 2019 

by  Aimee L. Wilcox, CPMA CCS-P CST MA MT

Are you aware of the ICD-10-CM code changes set take effect as of October 1, 2020? Do any of them apply to your organization? Which of them will be assigned as an HCC? What are the documentation and coding guidelines applicable to them and which guidelines are changing or being ...

Telehealth Policies for Medicare and Commercial Payers 

Telehealth Policies for Medicare and Commercial Payers

E/M and the Organ Systems Part 2 of 2 

E/M and the Organ Systems Part 2 of 2

E-M and the Organ Systems (Part 1) 

E-M and the Organ Systems (Part 1)

Chiropractic Manipulative Treatment and Medicare - Part 2 

by  Evan M. Gwilliam, DC MBA CPC CCPC CPC-I QCC MCS-P CPMA CMHP AAPC Fellow

In this CE webinar, Dr. Gwilliam will continue his discussion from the webinar delivered Dec. 18 about chiropractic manipulative treatment. But this time, it is all about Medicare. If you don't treat Medicare beneficiaries, you should probably listen anyway. Usually whatever Medicare wants is the same thing as all the other payers. Find out the difference between acute, chronic, and maintenance, as well as when to use certain modifiers.

Chiropractic Manipulative Treatment (CMT) Coding and Documentation (Part 1) 

by  Evan M. Gwilliam, DC MBA CPC CCPC CPC-I QCC MCS-P CPMA CMHP AAPC Fellow

The most used codes in chiropractic are 98940, 98941, 98942, and 98943. In this webinar, Dr. Gwilliam will go over the fundamentals of these codes and make sure you are proficient with them. They probably play a bigger part of your practice than any other code, so it is worth it to make sure you are reporting them correctly. By the end of this presentation you will be able to diagnose, document, and code properly for CMT, as well as avoid common mistakes.

The #1 most overlooked injury in PI, and it is found in over 90% of all cases 

by  Tom Grant Jr., DC

Presented by Tom Grant Jr. DC  December 11, 2018 Tuesday @ 10:15 AM PT, 11:15 AM MT, 12:15 PM CT, 1:15 PM ET *How to recognize this injury *The most effective documentation terms to use *The best combination of ICD-10 codes to validate it Register here: https://attendee.gotowebinar.com/register/8562161323381676035 ...

HCC Coding Tool 

by  Find-A-Code™

How to use Find-A-Code's HCC Coding Tool

Success with Out-of-Network Billing in Today's Environment Part 2 

by  Find-A-Code™

In this webinar Maxine will be presenting information and tips for understanding and billing Employment Retirement Income Security Act (ERISA) insurance plans. She will explain the rules and regulations concerning ERISA plans, as well as procedures for handling/appealing "adverse denials" of claims. Coders and Insurance Billing Specialists should not miss this informative presentation.

Success with Out-of-Network Billing in Today's Environment Part 1 

by  Find-A-Code™

In this webinar Maxine will be presenting information and tips for understanding and billing Employment Retirement Income Security Act (ERISA) insurance plans. She will explain the rules and regulations concerning ERISA plans, as well as procedures for handling/appealing "adverse denials" of claims. Coders and Insurance Billing Specialists should not miss this informative presentation.

Joints: Rotator Cuff, Elbow, Wrist, and Hand 

by  Find-A-Code™

In this webinar, Brandon will review the bones and major joints of the upper extremities (arm, forearm, wrist, hand, and digits), as well as their supporting structures and how they are affected by injury, disease, and other conditions.

All About Knee Coding & Auditing 

by  Find-A-Code™

Total knee replacement now acceptable ASC procedure also, not auditing for a year. Knee replacement coding, knee joint injections, auditing using FAC, LCDs, drugs, modifiers.

Evaluation and Management Coding and Auditing 

by  Find-A-Code™

Are you responsible for selecting or reviewing Evaluation and Management service levels? Do you wonder how well you know the rules and how to apply them? Join Aimee in this webinar to review and then applly the rules of E/M coding. She will also do a live demonstration of the new Find-A-Code E/M Calculator Tool to assess the level of E/M service for two office visits, one new (99201-99205) and the other established (99212-99215).

Coding and Auditing TeleHealth Services 

by  Find-A-Code™

Do you report or audit Telemedicine services now or are you considering offering them? Come and learn more about the rules and guidelines surrounding Telehealth services including, documentation requirements, eligible CPT and HCPCS Level II codes, modifiers, and the newest updates to Medicare Telehealth policies.

Using Find-A-Codes Anatomy Images 

by  Find-A-Code™

Diagnosis coding is difficult when clinician documentation does not match up with the definitions found in the ICD-10-CM code set. Find-A-Code's anatomy images educate both coders and students - bridging the gap between coders and clinicians while simplifying code selection.

FAC Updates Plus Tools for HCC Coding Chart Review February 

by  Find-A-Code™

Join Taylor to see how you can access free CEUs in 3 clicks, included with top-tier Find-A-Code subscriptions! Also highlighting our New and Improved NCDs system, and how to use the WK Drug Database for HCC Coding/Chart Review

2018 Updates and New Tools 

by  Find-A-Code™

2018 Find-A-Code updates and new tools

Proper Coding and Billing for Drugs, Biologicals and Injections 

by  Find-A-Code™

Proper Coding and Billing for Drugs, Biologicals and Injections

The Importance of Gathering Organizing and Using Fee Schedules 

by  Find-A-Code™

The Importance of Gathering Organizing and Using Fee Schedules

Using Find-A-Code's New Evaluation and Management Calculator Tool 

by  Find-A-Code™

Using Find-A-Code's New Evaluation and Management Calculator Tool

HCC Risk Adjustment 

by  Find-A-Code™

HCC Risk Adjustment

How to Report MIPS 

by  Evan M. Gwilliam, DC MBA CPC CCPC CPC-I QCC MCS-P CPMA CMHP AAPC Fellow

If eligible, you need to start reporting for MIPS by October 2th, 2017. Do you know who is exempt? Are you familiar with the quality measures that apply to chiropractors? Do you understand how to report on the Advancing Care Information or Improvement Activities? Don’t worry, Dr. Gwilliam has done all your homework and, in this presentation, you will get the crib notes containing just what you need to know. You don’t need to feel overwhelmed with Medicare regulations, you just need to know what to do.

Does a Self-Care Rx Effect Medical Reimbursement and How? 

by  Tom Grant Jr., DC

This is the easiest of therapies to initiate and it adds great medical value. Most DC's do not prescribe/proscribe self-care instructions. Self-care Rx's have defined timelines for implementation and updates. Done incorrectly, self-care Rx's damage medical value and decrease reimbursements.

How to Check NCCI Edits Using FindACode 

by  Find-A-Code™

How to Check NCCI Edits Using FindACode

ICD-10-CM Updates for the Auditor, a NAMAS webinar 

by  Find-A-Code™

ICD-10-CM Updates for the Auditor, a NAMAS webinar

ICD-10-CM Training - Session 01 

by  Find-A-Code™

ICD-10-CM Training - Session 01

ICD-10-CM Training - Session 02 

by  Find-A-Code™

ICD-10-CM Training - Session 02

ICD-10-CM Training - Session 03 

by  Find-A-Code™

ICD-10-CM Training - Session 03

ICD-10-CM Training - Session 04 

by  Find-A-Code™

ICD-10-CM Training - Session 04

ICD-10-CM Training - Session 05 

by  Find-A-Code™

ICD-10-CM Training - Session 05

ICD-10-CM Training - Session 06 

by  Find-A-Code™

ICD-10-CM Training - Session 06

ICD-10-CM Training - Session 07 

by  Find-A-Code™

ICD-10-CM Training - Session 07

ICD-10-CM Training - Session 08 

by  Find-A-Code™

ICD-10-CM Training - Session 08

ICD-10-CM Training - Session 09 

by  Find-A-Code™

ICD-10-CM Training - Session 09

ICD-10-CM Training - Session 10 

by  Find-A-Code™

ICD-10-CM Training - Session 10

ICD-10-CM Training - Session 11 

by  Find-A-Code™

ICD-10-CM Training - Session 11

ICD-10-CM Training - Session 12 

by  Find-A-Code™

ICD-10-CM Training - Session 12

ICD-10-CM Training - Session 13 

by  Find-A-Code™

ICD-10-CM Training - Session 13

ICD-10-CM Training - Session 14 

by  Find-A-Code™

ICD-10-CM Training - Session 14

ICD-10-CM Training - Session 15 

by  Find-A-Code™

ICD-10-CM Training - Session 15

ICD-10-CM Training - Session 16 

by  Find-A-Code™

ICD-10-CM Training - Session 16

ICD-10-CM Training - Session 17 

by  Find-A-Code™

ICD-10-CM Training - Session 17

ICD-10-CM Training - Session 18 

by  Find-A-Code™

ICD-10-CM Training - Session 18

ICD-10-CM Training - Session 19 

by  Find-A-Code™

ICD-10-CM Training - Session 19

ICD-10-CM Training - Session 20 

by  Find-A-Code™

ICD-10-CM Training - Session 20

ICD-10-CM Training - Session 21 

by  Find-A-Code™

ICD-10-CM Training - Session 21

ICD-10-CM Training - Session 22 

by  Find-A-Code™

ICD-10-CM Training - Session 22

ICD-10-CM Training - Session 23 

by  Find-A-Code™

ICD-10-CM Training - Session 23

ICD-10-CM Training - Session 24 

by  Find-A-Code™

ICD-10-CM Training - Session 24

ICD-10-CM Training - Session 25 

by  Find-A-Code™

ICD-10-CM Training - Session 25

ICD-10-CM Training - Session 26 

by  Find-A-Code™

ICD-10-CM Training - Session 26

ICD-10-CM Training - Session 27 

by  Find-A-Code™

ICD-10-CM Training - Session 27

ICD-10-CM Training - Session 28 

by  Find-A-Code™

ICD-10-CM Training - Session 28

ICD-10-CM Training - Session 29 

by  Find-A-Code™

ICD-10-CM Training - Session 29

ICD-10-CM Training - Session 30 

by  Find-A-Code™

ICD-10-CM Training - Session 30

ICD-10-CM Training - Session 31 

by  Find-A-Code™

ICD-10-CM Training - Session 31

ICD-10-CM Training - Session 32 

by  Find-A-Code™

ICD-10-CM Training - Session 32

ICD-10-CM Training - Session 33 

by  Find-A-Code™

ICD-10-CM Training - Session 33

ICD-10-CM Training - Session 34 

by  Find-A-Code™

ICD-10-CM Training - Session 34

ICD-10-CM Training - Session 35 

by  Find-A-Code™

ICD-10-CM Training - Session 35

ICD-10-CM Training - Session 36 

by  Find-A-Code™

ICD-10-CM Training - Session 36

HIPAA Has New Requirements (New as of 2013-11-07) 

by  Wyn Staheli, Director of Content - innoviHealth

HIPAA Has New Requirements ...

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