Make sure your documentation supports the additional substantial complexity of the hernia repair and mesh.
Question: A patient presented for a colectomy for colon cancer. The physician also discovered that the patient had a ventral incarcerated hernia that required a…
Bonus: Get exposure to ICD-10 coding equivalents.
Question: A mentally-challenged patient who delivered at home was admitted to the hospital for postpartum care. The patient delivered the placenta at home, and once admitted, she had no complications, but the ob-gyn…
Medicare’s elimination of payment for consultation services has caused mass confusion throughout the coding community, not just due to the changes it has caused in your billing procedures, but also due to lack of information from CMS.
In an apparent…
Don’t forget to include the code for the arthrocentesis.
Question: A new patient sees the orthopedist because of shoulder problems. The physician schedules an MRI and the patient returns the following week to discuss the findings. The physician had already…
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On Tuesday evening, the Senate passed H.R. 4691, which freezes the Medicare conversion factor at current levels through March 31.
Because of this vote, you will not face the 21% pay cut until April 1, explains Part B Insider editor,…
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The latest on the 21 percent Medicare pay cut.
If your practice leans heavily on Medicare for reimbursement, expect your cash flow to taper off a bit.
CMS has instructed the MACs to hold claims for the first ten business…
No severe problems? You may have trouble with reimbursement. Question: The ob-gyn performed and OB ultrasound (US) on a patient. Can I bill 76376 in addition to the ultrasound if the ob-gyn used 3D? Montana Subscriber Answer: Yes. You can report a 3D procedure with 76805 (Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation, [...] Related articles:
Record visual fields interpretation and report the right way. Visual fields are a compliance hot spot. Optometrists should use the visual field interpretation and report (I&R) to record what their thinking process was at that moment by recording any changes noticed, how the field compares to other testing like OCT (92135, Scanning computerized ophthalmic diagnostic imaging, [...] Related articles:
Discover what the 5th digit represents and why you need it on your claim. Question: A presents to the ED with complaints of a headache that’s worsening daily. He is experiencing visual blurring and nausea but no vomiting. This is the third headache of this nature in three weeks, and it has lasted “four or five [...] Related articles:
Fear not: The CF may stay until autumn, but the current snow storm is delaying the official word. Practices that were looking for a permanent change to the sustainable growth rate (SGR) formula before March 1 may come up empty-handed. However, Congress appears to be planning to offer an extension of the pay cuts that you’re [...] Related articles:
Verify co-pay early to save time, money Question: A patient came to our office for a routine exam with the same insurance card she’s had for years. We charged her the standard copay of record. Then I found out her employer changed the terms of the insurance, so the copay she paid was short by $20. [...] Related articles:
Beware: Don’t use the CMS consult crosswalk for billing purposes. You may be seeing light at the end of the tunnel. The AMA just published an article to clarify the use of the consultation codes for non-Medicare patients, and talks about their efforts to get CMS to delay their new policy. You can find the article [...] Related articles:
Question: A local family physician refers a patient to our gastroenterologist for a diagnostic colonoscopy. The patient reports to the practice and meets the gastroenterologist for the first time. After answering some patient questions during a brief introduction, the gastroenterologist performs a diagnostic colonoscopy with brushing. The patient had never met the gastroenterologist before. Is the time he spent with the patient [...] Related articles:
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:
Different calendar dates matter, but multiple instillations the same day do not. Question: My pulmonologist inserted a chest tube and then instilled a fibrinolytic agent to break up multiloculations to free up an entrapped lung. Usually, I use 32560 for this procedure, which is for pleurodesis, not fibrinolysis. What code should I use for fibrinolytic agent [...] Related articles:
Want to know what RAC contractors will be looking for next? Here’s the link. Recovery audit contractors (RACs) are working hard to expand their lists of approved issues, and you should keep a close eye on your services in these areas as well. Health Data Insights (HDI), the RAC contractor for Region D, posted 66 new approved [...] Related articles: