Enhancing Patient Care with Clinical Documentation Improvement

Clinical documentation improvement (CDI) ensures that health services are accurately documented and helps healthcare coders and physicians work toward improved patient care while also streamlining productivity. When meaningful clinical data…

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ICD-10 Data: Does It Matter?

It is often argued that ICD-10 coding does nothing for the patient. Recently that point was made at the U.S. House Energy & Commerce Subcommittee on Health hearing "Examining ICD-10 Implementation" last week.

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Surgical Coders: Don’t Overstate Debridement

Tip: This encounter involves topical applications and patient care instruction in addition to removing devitalized tissue.

Question: When the surgeon performs a wound VAC or cleans a wound by scraping with a sharp curette (not excising tissue), is it appropriate to use a debridement code or should we report an active wound care management code from the range 97597-97606?

Ohio Subscriber

Answer: Physicians typically use the debridement codes (11000-11001, Debridement of extensive eczematous or infected skin; … or 11004-11005, Debridement of skin, subcutaneous tissue, muscle and fascia for necrotizing soft tissue infection; …) for debridement by any method.

Without...

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CMS Changes Conversion Factor Yet Again

Plus: Look for an increase in your DEXA scan reimbursement.

The bad news: Your carrier won’t be paying your claims using the conversion factor of $36.0846 anymore.

The good news: CMS is only changing the conversion factor by less than a penny, making it $36.0791, according to CMS Transmittal 700, issued on May 10. MACs will use this 2010 conversion factor to calculate your payments, but keep in mind that after May 31, you’re still due to face a 21 percent pay cut unless Congress intervenes. Keep an eye on the Insider for more information on whether Congress steps in...

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Cataract Surgery Coding: When Optometrist Provides Postop Care

We’ve got the modifier you need when the ophthalmic surgeon passes the baton. Question: An ophthalmic surgeon performs cataract surgery, and then turns the patient over to the optometrist for postoperative management only. How should I code between the two providers? Do I need a modifier? Answer: If the ophthalmic surgeon turns the patient over to the [...] Related articles:

  1. Optometry Coding: Eye Exams, Cataract Surgery and Co-ManagementE/M or Eye Code? Choose Wisely With These Documentation Tips...
  2. Ophthalmology Coding: See Your Way to Clear Reimbursement for Eye Exams and Cataract SurgeryChoose the Right E/M or Eye Code to Optimize Reimbursement...
  3. Cataract Removal Eye-Opener: 66984CPT 66984 is the number-one procedure performed in ASCs, according...

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CPT 2010 Update: Non-Face-to-Face Prolonged Services

New Year’s hats & horns for looser guidelines that let you count work spread over days. Groaning thinking of all the time you’ll never capture for complex cases requiring extensive pre-visit time? CPT 2010 brings you hope. Extensive guideline revisions “liberalize prolonged non-face-to-face services codes,” reports Richard Tuck, MD, FAAP, pediatrician at PrimeCare of Southeastern Ohio in [...] Related articles:

  1. Asthma Attack Coding: When To Use Prolonged or High-Level E/M     Checklist deters payback requests for insufficient +99354...
  2. Bust 4 Myths About Pediatric Critical Care Services MYTHBUSTER: Codes 99291, +99292 apply to infants, young pediatric...
  3. Watch Out for 3 Telephone Service Coding PitfallsCaution: You may need to incorporate the call into an...

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