Category: Coding & Documentation

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Does My Documentation Tell the Story in Critical Care?

Does My Documentation Tell the Story in Critical Care? SCCM Critical Connections – August 2019  by Deb­o­rah Grider The initial and subsequent hospital codes 99221-99233 require specific documentation of the key components: history, examination, and medical decision-making. Read Full Article Copyright© 2019 The Society of Critical Care Medicine.

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Selling your practice? Clean up the coding first.

Selling your practice? Clean up the coding first. Physicians Practice Pearls – March 2019  by Karen Zupko As more and more practices are courted for acquisition, our firm is being engaged by both buyers and sellers to evaluate the accuracy of coding and documentation, and the efficiency of the revenue cycle. The results of these...

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Understand CMS Advanced Billing Practitioner Professional Billing

Understand CMS Advanced Billing Practitioner Professional Billing ICD-10 Monitor – January 2019  by Deb­o­rah Grider Not billing the APP service can result in serious revenue cycle errors. Many providers are still struggling with the non-physician practitioner (NPP) billing rules from the Centers for Medicare & Medicaid Services (CMS). Most facilities are now referring to NPPs as...

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Medical Necessity Monopoly: How to Avoid “Chance” and Advanced to “Go”

Medical Necessity Monopoly: How to Avoid “Chance” and Advanced to “Go” AAOSNow – November 2018 by Karen Zupko and Michael Marks, MD, MBA A three-step medical necessity action plan can help ensure payment Consider the following: A patient presents to your office complaining of symptoms that indicate a possible herniated disk. A history notes symptoms following...

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The Value of Claims ‘Signal’ Data in Orthopaedic Surgery

The Value of Claims ‘Signal’ Data in Orthopaedic Surgery AAOSNow – January 2019  by Michael Marks, MD, MBA In last month’s article, “Scientific Analysis for Medical Liability Claims,” Coverys’ Robert Hanscom, vice president of business analytics, and Lisa Simm, manager of risk management, presented the methodology the insurer utilizes to analyze medical professional liability (MPL) claims....

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