Coding Experts Weigh in on the Value of Code-X AAOS Now – May 2019 by Cheryl Toth If you are looking for an electronic tool that makes code selection easier and gives your practice powerful data for reducing denials, strengthening appeals, and validating plan payments, the Academy’s Code-X software tool is a good choice. Code-X is a...
Category: Coding & Documentation
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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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Revisiting Neonatal and Pediatric Critical Care Services
Revisiting Neonatal and Pediatric Critical Care Services SCCM Critical Connections – February 2019 by Deborah Grider Neonatal and pediatric critical care coding guidelines have been modified over the years, but the definitions remain the same. Read Full Article Copyright© 2019 The Society of Critical Care Medicine.
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2019 Billing and Coding Changes for Peripherally Inserted Venous Catheters
2019 Billing and Coding Changes for Peripherally Inserted Venous Catheters SCCM Critical Connections – February 2019 by Deborah Grider Central venous access procedures, commonly performed in critical care, have undergone a change in CPT 2019. Read Full Article Copyright© 2019 The Society of Critical Care Medicine.
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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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Major Challenges Face Coders in 2019 and Beyond
Major Challenges Face Coders in 2019 and Beyond ICD-10 Monitor – December 10, 2018 by Deborah Grider CPC, COC, CPC-I, CPC-P, CPMA, CEMC, CCS-P, CDIP ddress documentation and coding issues up front, rather than correct them later. Coders have had many challenges throughout the years. When I started in the industry, we did not submit...
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Highlights of the Medicare Physician Fee Schedule Final Rule
Highlights of the Medicare Physician Fee Schedule Final Rule RAC Monitor – November 14, 2018 by Deborah Grider CPC, COC, CPC-I, CPC-P, CPMA, CEMC, CCS-P, CDIP Highlights of the 2019 Medicare Physician Fee Schedule, released on Nov. 1, are provided by the author. There will be no change in E&M payment levels for 2019, as...
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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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Is ‘Insurance Only’ Billing Advisable?
Is ‘Insurance Only’ Billing Advisable? AAOSNow – January 2019 by Cheyenne Brinson and Patricia Hofstra Surgeons instructing billing staff to bill “insurance only” is a scenario that is all too common in orthopaedic practices. In effect, the practice is waiving the patient’s copay, coinsurance, and deductible amounts and accepting whatever amount the insurance company will pay....