CMS / E/M / Hot Coding Topics

Get Paid for EM Visits: How Much ROS Documentation Is Enough?

Caution: Keep enough paperwork on hand to back up EHR. Transitioning to the world of Electronic Health Records (EHR) can make your coding easier on many levels, but don’t take it for granted. Physicians often fall short in their review of systems (ROS) documentation whether you use paper charts or rely on EHR, but you can [...] Related articles:

  1. Bullet-Proof Level-4, Level-5 E/Ms with These ROS Documentation TipsROS documentation musts that most practices get wrong. Gastroenterology Coders:...
  2. E/M Coding Focus: Geriatric Patients & DementiaDetermine HPI or ROS during assessment for geriatric patients. Your...
  3. Bulletproof Your Doc’s PSA Documentation with This Form You’re just one click away from a code-focused order....

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February 25, 2010
CMS / MAC / Provider News

CMS Delays Ordering/Referring PECOS Regulation Until 2011

Take the extra time to get your practice registered in PECOS — don’t wait until the end of the year, CMS reps say. Practices that were busily struggling to find out whether their ordering/referring physicians’ national provider identifiers (NPIs) were in the PECOS system can relax a little bit — at least until next year. If your physician performs [...] Related articles:

  1. CMS: Billing Co. Can’t Fill Out PECOS Form on Doc’s BehalfIf you’ve grown accustomed to a designated credentialing specialist in...
  2. A Press Release Is Not a Legal Ruling, PECOS Pundits Point OutKeep an eye on the Federal Register as you use...
  3. CMS Changes Course: Physicians Need Not Personally Complete PECOS ApplicationWhat a difference three months makes, especially when it comes...

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February 23, 2010
Anesthesiologist / Coding Challenge

Burn Coding: Calculate Total Body Surface Area (TBSA)

Investigate your physician’s documentation to determine the body area percentage actually debrided. Question: My anesthesiologist administered anesthesia for a burn excision on the leg of a middle-aged adult male, but he didn’t give clear notes on the patient’s affected body surface area. How do I code for this? Kansas Subscriber Answer: You will start by coding 01952 (Anesthesia [...] Related articles:

  1. Double Your Money When You Spot E/M and Burn Treatment on Same ED Claim The key component of 16000 puts burn coding questions...
  2. Test Yourself: Total Knee Replacement (TKR) Coding Can you tackle an op note like this one...
  3. Coding Challenge: Foot Foreign Body Removal Vs. Soft-Tissue FBRQuestion: Our physician performed a foreign-body removal (FBR) on a...

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February 17, 2010
CMS / E/M / MAC / Provider News

CMS Will Soon Issue Consult Code Replacement Advice, According to Open Door Forum

Plus: You can now download a list of all practitioners who can order/refer. If you’ve been confused about how to report low-level hospital visits now that consult codes are gone, you aren’t alone. CMS intends to tackle this problem by issuing more specific guidance on the topic in the near future. That’s according to a Feb. 2 [...] Related articles:

  1. CMS Open Door Forum: RACs Are BackPlus: Medicare officials clarify who can bill incident-to services and under...
  2. Proposed 2010 MPFS: $26 More for ‘Welcome to Medicare’ ExamCMS welcomed health care providers to an July 9 open...
  3. Ask 3 Questions to Head Off 2010 Consult Problems Before They Start Ever used an unlisted E/M code? Get ready. By...

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February 9, 2010
CMS / Toolkit

Want to Integrate PQRI Measures Into Your Practice? Look Here.

Participation can put extra bread in your basket. Back again for 2010 is Medicare’s incentive-driven physician quality reporting initiative (PQRI), aimed at tracking quality metric or patient care services that physicians provide. When the practice treats enough patients in the same category, some PQRI dollars might be only a few codes away. If you know the basics [...] Related articles:

  1. PQRI 2010: Tips That Boost Your Practice’s RevenueFollow our links and advice to put more plusses in...
  2. New PQRI, E-Prescribe Tool from CMS If your head is spinning with all of the...
  3. Keep These 2009 PQRI Eye Care Measures HandyOphthalmologists and optometrists who want to recoup a bonus from...

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January 28, 2010
CPT 2010 / Hot Coding Topics

PQRI: No Coumadin Due to Fall Risk

Plus, experts at the AMA meeting in Chicago tell you what to do if you can’t get H1N1 vaccine for PQRI Measure 110 or other vaccine measures. Question: My internist decided not to put a patient on Coumadin because the patient has a higher risk of falling than from having a stroke. Our group participates in [...] Related articles:

  1. Smokin’ PQRI Pointers We’ve got the G codes you need to score...
  2. Make Sure These Errors Don’t Sink Your PQRI BonusCMS shows which issues sidelined these practices. Most practices would...
  3. Track Payer’s Preferred H1N1 Admin Code — or Risk RejectionsCode 488.1 does not = confirmed lab. Swine flu has...

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November 13, 2009
Coder's Cranium / Medicare / Oig

Nonphysician Providers and Incident-To: Your Coding Questions Answered

Here’s why you should keep your physicians’ work schedules on file. Correctly billing your nonphysician practitioners (NPPs) incident-to services means the difference between 85 and 100 percent reimbursement. But if you bill incident-to haphazardly, you’re just waving a red flag at auditors. And those auditors are jonesin’ to find incident to billing problems. Just check out this [...] Related articles:

  1. Nonphysician Providers & Incident To ChecklistCheck state laws PLUS this crucial document. In last week’s...
  2. Steer Your Incident-To Coding Using These 4 Questions 100 percent pay possible if NPP follows internist’s care...
  3. Use This Incident-To Checklist to Breathe Easy During an Audit You don’t need to second-guess the way you bill...

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October 25, 2009