Physicians will potentially have a lighter documentation burden and more time to spend with patients in 2021 thanks to an overhaul of Medicare Coding guidelines for outpatient evaluation and management (E/M) services. “The whole point was to have people not document stuff that was not necessary, not relevant to the clinical management of the patient,” […]
MACs may be applying the multiple endoscopy rules incorrectly. In the 2020 Medicare Physician Fee Schedule (MPFS) Final Rule, the Centers for Medicare & Medicaid Services (CMS) finalized the proposal to apply the special rule for multiple endoscopic procedures to the family of functional endoscopic sinus surgery (FESS) codes. Practices are now getting remittance advice […]
February is the month of love, where every valentine will wait to celebrate and every single will wait to became a couple. In this day will anybody think about the medical billing and medical coding, absolutely not? However you need to be prepared for all sweet happening and mishaps for Valentine’s Day in 2025. No […]
Dive Brief: In the first two years diagnostic codes specific to social determinants of health were available in Medicare fee-for-service claims, they were used for only 1.4% of the total beneficiary population, according to a new report from CMS. Use of the Z codes, first implemented for Medicare FFS in 2016, increased slightly from that […]
Confusion and apprehension surround new guidelines for deep-tissue pressure injury. The release of the 2020 Official Guidelines for Coding and Reporting (OCG) has resulted in confusion and apprehension surrounding the intent of the new guideline related to the new ICD-10-CM codes for pressure-induced deep-tissue damage, or deep-tissue pressure injury (L89.-6). The ambiguity stems from what […]
Quite a few code changes and revisions were made to the Radiology Code section of CPT Code for 2020. Less confusing language and expanded code categories will make life easier for medical coders. Here’s a quick review. Gastrointestinal System A mini overhaul of the gastrointestinal system codes removed the confusing language of “with or without […]
Coronavirus is spreading. As of Jan. 27, eight cases of a novel coronavirus (2019-nCor) have been reported in the United States. The outbreak that started in Wuhan, China has spread to four states – Washington, California, Arizona, and Illinois. In China, there are close to 2,000 cases that have been confirmed, with 56 deaths. Cases […]
The number of conditions a patient has is now going to factor into the risk adjustment score (RAS). In March, I make my annual pilgrimage to Columbus, Ohio to speak at the Ohio Health Information Management Association (OHIMA) conference, and this year, my remarks are titled, “The Hierarchical Condition Categories Model: Risk Adjustment isn’t just […]
New patient evaluation and management (E/M) claims are being denied when the patient was previously seen by a specialty physician assistant or specialty nurse practitioner on staff. This is happening when another provider of a different specialty in the same multi-specialty group sees the patient for the first time and bills a new patient E/M […]
Anyone who has viewed the wildfires in Australia knows why it has been called the “canary in the coal mine” of climate change. No wonder that Solastalgia was discovered there. As the ever-increasing carbon is being emitted from the world’s coal mines and other fossil fuel sources, life as we know it is at increased […]