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June 16th, 2022
2022-05-26-MLNC - Biosimilars: Interchangeable Products May Increase Patient Access
Published June 16th, 2022|
News - COVID-19: New Administration Code for Pfizer Pediatric Vaccine Booster Dose - - Biosimilars: Interchangeable Products May Increase Patient Access - - Critical Care Evaluation & Management Services: Comparative Billing Report in May - -...
June 7th, 2022
Do You Know What Code is Used to Report Long-Haul COVID-19 Conditions?
Published June 7th, 2022|
A new code was added to the ICD-10-CM official code set with an effective date of October 1, 2022 for reporting post-COVID-19 sequela. We have all heard about people having odd conditions following COVID-19, well now there is a code available for reporting all of these anomalies, but are you familiar with the code and the rules for reporting it?
April 27th, 2022
How to Reduce the Risk of Copy and Paste
Published April 27th, 2022|
Providers should never C&P (copy and paste) material they have not read nor vetted for accuracy. A young Jeopardy! champion died from bilateral pulmonary emboli following a colectomy in January 2021. Following his surgery, it was reported that the surgeon referred to “DVT/VTE Prophylaxis/Anticoagulation” and another note read, “already ordered.” “DVT...
April 13th, 2022
Hepatic Fibrosis Coding — Are Your Bases Covered?
Published April 13th, 2022|
Patients are generally diagnosed when they reach End Stage Liver Disease (ESLD) by undergoing a liver biopsy. This creates higher healthcare costs and higher risks of complications and mortality. However, newer non-invasive tests now exist that can help in the assessment and early detection of hepatic fibrosis before it reaches the level of cirrhosis.
February 10th, 2022
SDoH Improves Reimbursement and Risk Scores
Published February 10th, 2022|
The new guidelines for evaluation and management (E/M) services 99202-99215 refer to social determinants of health (SDoH) on the new or revised Table of Risk. Healthcare professionals have long hoped for the ability to score these problematic patient conditions in a meaningful way, not only for reimbursement, but also for quality of care and treatment options. SDoH codes recently added to the ICD-10-CM codeset continue to impress upon us the importance of identifying and reporting these patient issues and when combined with the new table of risk for scoring the E/M service, can impact reimbursement and care.
February 9th, 2022
How Soon Will the United States Adopt ICD-11?
Published February 9th, 2022|
The ICD-11 diagnostic codeset went into effect worldwide on January 1, 2022 and has been adopted by some countries while others are still considering implementation, including the United States. The changes from ICD-9 to ICD-10 were significant but the change to ICD-11 will include the addition of new chapters, concepts, and symbols like the ampersand (&). Take a minute to familiarize yourself with this diagnostic coding set. The goal is to adopt a single version that has the flexibility to accommodate future code revisions and additions.
October 14th, 2021
Five Major ICD-10-CM Changes That Can Effect Your Organization
Published October 14th, 2021|
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.
October 6th, 2021
ICD-10-CM Cracks Down on the Use of "Unspecified" in the 2021 Official Guidelines
Published October 6th, 2021|
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.
October 4th, 2021
Watch out for New ICD-10-CM Codes
Published October 4th, 2021|
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.
July 19th, 2021
Chronic Pain Coding Today & in the Future
Published July 19th, 2021|
Properly documenting and coding chronic pain can be challenging. As is commonly the case with many conditions, over the years, there has been a shift in the identification of different types of pain, including chronic pain. Understanding where we are now and where we are going will help your organization prepare for the future by changing documentation patterns now.
July 14th, 2021
How to Properly Assign ICD-10-CM Codes for Pain
Published July 14th, 2021|
Pain is a common diagnosis among all specialties so it should not be surprising to find there are 162 ICD-10-CM codes for reporting it and over 80 mentions in the ICD-10-CM Official Guidelines for Coding and Reporting which describe when certain types of pain should be reported and how the codes should be sequenced.
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?
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May 11th, 2021
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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