It seems the only things more complex than wounds today are the rules about getting paid for treating them. That's likely what many smaller nursing home administrators will say as…
“Unified clinical pathways providing minimal guidelines on the best medical practices” is a solution for the current gap between medical necessity and insurance coverage, according to a leading provider of…
The health care industry is “not progressing at a suitable pace” to be ready for tens of thousands of new government-mandated “ICD-10” codes used to describe diseases and hospital procedures…
Accurate medical coding and billing solutions for specialty physicians and surgery centers benefit them in a number of ways. These solutions are available for a wide range of medical specialties…
In a video statement issued late Tuesday afternoon Medical Coding Pro denied that any "hidden messages" are used in Laureen Jandroep's Blitz Videos to increase the pass rate of the…
Physicians are very often so stressed out with seeing an increasing number of patients, providing medical services and appropriate follow-ups that they hardly get any time to see to the…
As U.S. health care providers continue the march toward implementing the ICD-10 — a standardized set of medical diagnoses used by medical professionals across the world — the code set…
What A Thorough Medical Coding Career Description Contains ... www.raritanhighlands.org3/24/11 What A Thorough Medical Coding Career Description Contains When you are looking for a medical coding career description, you most…
The HHS Office of Inspector General (OIG) Work Plan for Fiscal Year 2012 provides brief descriptions of activities that OIG plans to initiate or continue with respect to HHS programs and operations in fiscal year 2012.
Raise your glass to the new year without worries of 2011 medical code changes. SuperCoder’s got you covered with new CPT codes, CCI edits, and supply coding revisions. Starting Dec. 31, SuperCoder.com will offer the complete codesets for CPT 2011...
600 coders, physicians, and office managers gathered in Orlando, Fla. for one and a half jam-packed days of education, networking, and shopping at the December 2011 Coding Update and Reimbursement Conference. Coders’ biggest struggle was absorbing all the information – and not overdoing the holiday buying. Experts offered the inside scoop on medical coding changes for 2011 and beyond. Here are my top picks:
This...
Question: I’m receiving contradictory guidance on which modifier to use when a gastroenterologist does an incomplete colonoscopy. Should I use modifier 52 or 53? Answer: CPT 2011 ends the days of arguing over whether to use modifier 52 or 53 for ...
Get ready to change your flu vaccine product code 90658 to one of four Q codes. For 2010, report 90658 (Influenza virus vaccine, split virus, when administered to individuals 3 years of age and older, for intramuscular use) to signify that your physici...
Medicare beneficiaries will be thrilled that Medicare will cover annual well checks. The Center for Medicare introduces a new benefit of wellness visits for beneficiaries annually, except during the year of their Welcome to Medicare exam. You’ll use ...
Medically unlikely edits ignorance could be causing you medical coding claim denials.
Ensure you’re not letting medically unlikely edits (MUEs) wreak havoc on your urology practice’s coding and reimbursement by uncovering the truth about four aspects of these edits.
Myth 1: MUE Edits Don’t Affect Your Practice
Some practices feel that they don’t need to worry about MUEs.
Reality: “They limit the frequency a CPT code can be used,” says Chandra L. Hines, business office manager at Capital Urological Associates in Raleigh, N.C. “With our specialty of urology, we need to become aware of the denials and not let every denial go because the insurance company said it was an MUE. We should all be aware of MUEs as they occur, and we cannot always control whether or not we will receive payment.”
The MUE list includes specific CPT or HCPCS codes, followed by the number of units that CMS will pay. CMS developed the MUEs to reduce paid claims error rates in the Medicare Program. The first edits were implemented in January 2007, although some of the edits themselves became public in October 2008.
Some MUEs deal with anatomical impossibilities while others edit automatically the number of units of service you can bill for a service in any 24-hour period. Still others limit codes according to CMS policy. For example, excision of a hydrocele, bilateral (55041) has a bilateral indicator of “2,” so you should never bill two or more units of this code. Additional edits focus on the nature of the equipment for testing, the study or procedure, or pathology specimen.
Anatomical example: The MUEs edit out and deny an erroneously coded claim for a circumcision (54161, Circumcision, surgical excision other than clamp, device or dorsal slit; older than 28 days of age) for a patient...
You can sit back and enjoy the fall foliage spectacle — SuperCoder.com’s got your ICD-9-CM 2011, National Correct Coding Initiative 16.3, and October Medicare Physician Fee Schedule medical coding updates covered. Go ahead and search for th...