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State Specific Medical Coding Resources

articles, webinars, links, files and other resources for state specific coding, reimbursement and compliance

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Preview the PDGM Calculator for Home Health Today


Until February 1, 2020, you can preview Find-A-Code's Patient-Driven Groupings Model (PDGM) home health payment calculator by going to .

tags  Specl: Home Health|Hospice    Topic: Fees   

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...

tags  Loc: All Locations    Payer: All Payers    Specl: Billing    Specl: Cardiology|Vascular    Specl: Emergency Medicine    Specl: Gastroenterology    Specl: General Surgery    Specl: Interventional Radiology    Specl: Neurology|Neurosurgery    Specl: Orthopedics    Specl: Radiology    Specl: Rheumatology    Specl: Urology|Nephrology    Topic: Auditing    Topic: Coding    Topic: CPT Coding    Topic: Procedure Coding   

Modifier 50 — Four "Must Know" Tips For Getting Paid


Modifiers added to an HCPCS or CPT© code alters the code description, providing clarity about the service for proper claim processing and reimbursement. Here are four things you must know about modifier 50 to ensure proper payment. - Modifiers are either informational or payment related. Informational modifiers provide additional...

tags  Specl: All Specialties    Topic: CPT Coding    Topic: Modifier Coding    Topic: Procedure Coding   

Q/A: Can I Order a TENS unit for a Medicare Patient?


Question Can a chiropractor order a TENS unit for a Medicare patient? We cannot order X-rays for a Medicare patient so I assume we cannot order a TENS unit either. Answer It’s not that you can’t order the TENS unit, it’s just that when it comes to doctors of chiropractic, Medicare only covers ...

tags  Payer: CMS|Medicare    Specl: Chiropractic    Topic: Supply Coding   

Answering the Question: Does my Insurance Cover Chiropractic Care?


The question "Does my insurance cover chiropractic care" is the ongoing question chiropractic offices have struggled with for years. Unfortunately, when it comes to insurance, coverage often varies between payers — even varying between plans for a single payer so there isn't one easy answer.

tags  Specl: Chiropractic    Topic: Insurance   

"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: ...

tags  Loc: All Locations    Payer: All Payers    Specl: All Specialties    Topic: Auditing    Topic: Billing    Topic: Claims Processing    Topic: Coding    Topic: Compliance    Topic: CPT Coding    Topic: Diagnosis Coding    Topic: ICD10CM Coding    Topic: Practice Management    Topic: Reimbursement    Topic: Technology   

New Medicare Home Health Care Payment Grouper — Are You Ready?


In 2020, Medicare will begin using a new Patient-Driven Groupings Model (PDGM) for calculating Medicare payment for home health care services. This is probably the biggest change to affect home health care since 2000.

tags  Specl: Home Health|Hospice    Topic: Fees   

Hypertension ICD-10-CM Code Reporting Table


In ICD-10-CM, hypertension code options do not distinguish between malignant and benign or between controlled and uncontrolled. What is important for code selection is knowing if the hypertension is caused by or related to another condition. The following table shows some of these options.

tags  Specl: All Specialties    Specl: Anesthesia|Pain Management    Specl: Neurology|Neurosurgery    Specl: Obstetrics|Gynecology    Specl: Ophthalmology    Specl: Optometry    Specl: Oral and Maxillofacial Surgery    Topic: ICD10CM Coding   

VA: How UCR Charges are Determined


How does the VA determine charges billed to third party payers for Veterans with private health insurance? According to the VA. "38 C.F.R 17.101 stipulates the basic methodology by which VA bills third party insurance carriers. In order to generate a charge for medical services, VA establishes reasonable charges for five ...

tags  Payer: VA - Veterans Administration    Topic: Fees   

Q/A: How do I Code a Procedure for the Primary Insurance so the Secondary Can Get Billed?


Question: How do you modify a code submitted to the primary insurance company to let them know it is not covered by them so you can bill to a secondary?

tags  Specl: Chiropractic    Topic: Billing    Topic: Modifier Coding   

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