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For ICD-10-CM, ICD10-PCS, CPT, and HCPCS Code Sets
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June 1st, 2021
Managed Care Organizations Use CMS Tools to Identify Outliers
Published June 1st, 2021 - Last Review/Update June 2nd, 2021|
Managed Care Organizations (MCOs) include risk-adjusted plans whose funding is based on the health status of their beneficiaries. Government-funded MCOs use CMS information to search for suspected cases of fraud and abuse.
May 18th, 2021
OIG Plans for Onslaught of Risk Adjustment Audits Claiming 9.5% Error Rate in Code Assignment
Published May 18th, 2021|
As the OIG has published their intent to further investigate the 9.5% of improper payments based on incorrect ICD-10-CM code assignation, they implore Managed Care Organizations (MCOs) to begin employing some of the CMS tools and data analytic programs used to help identify outliers.
April 20th, 2021
ICD-11 — What’s Happening?
Published April 20th, 2021|
ICD-11 is officially released, but what does that mean for diagnosis coding in the United States? What's really different? This article discusses what has been happening with ICD-11, some interesting things to note about it, as well as links to other important information.
March 17th, 2021
Q/A: Why is My Claim Being Denied When I Report a Secondary Diagnosis Code?
Published March 17th, 2021|
Question: Recently my claims to Medicare are being denied when I submit a secondary diagnosis code. I’ve heard that this is happening in several states including Washington, California, and New York. Has there been a recent change in what secondary diagnosis codes are allowed?
October 1st, 2020
New Codes for Cytokine Release Syndrome (CRS)
Published October 1st, 2020 - Last Review/Update October 6th, 2020|
New codes for Cytokine Release Syndrome (CRS) are effective October 1, 2020 based on the grade/severity of the symptoms. This article covers the new grading scales.
June 10th, 2020
MEGA - NCCI Edit Changes - WHO Knew?
Published June 10th, 2020|
There was no huge announcement when CMS released new files in April. The files that were released on April 7, 2020, actually replaced files to update the NCCI edits on Procedure to Procedure (PTP) edits and Medically Unlikely Edits (MUE). The updated files included; 291,902 Deleted Procedure to Procedure (PTP) edits 197 Deleted Medically Unlikely ...
March 24th, 2020
"What is the ICD-10 code for...?" - Search Smarter With Find-A-Code Tools
Published March 24th, 2020|
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: ...
February 19th, 2020
Q/A: Did Noridian Stop Covering the M99.0- Codes?
Published February 19th, 2020|
Question: I heard that Medicare Noridian Jurisdiction F (Alaska) has been denying claims with M99.00, M99.01, M99.02, M99.03 etc codes when billed with the CMT CPT codes. Did Medicare change their policy?
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May 11th, 2021
May 11th - Diagnosis Coding and Documentation - Tips and Tricks
January 23rd, 2020
What Are ICD-10 Codes and What Has Changed Since Implementation?
Some of the most often searched questions on the internet include, what are ICD 10 codes, how many ICD 10 codes are there, what does ICD 10 CM stand for, when did ICD 10 start, and everyone’s favorite coding question, “what is the ICD 10 code for… (fill in the blank). It’s been a few years since ICD-10-CM was released and implemented and a lot has changed. In this webinar we will discuss
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