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 2020. […]
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 […]
Scour the documentation for three key details to correctly code for wound repair. Accurately coding dermatological procedures can be tricky. It is imperative that medical coders understand the anatomy of the skin and can extract specific information from the clinical documentation. We’ve spent the last two months reviewing the codes and guidelines for damaged skin […]
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 […]
The clock is ticking, and you’re trying to select the right E/M level from a drop-down menu in the EHR. Choose a level that’s too high, and you run the risk of post-payment audits and recoupments. Choose one that’s too low, and you may lose revenue to which you’re entitled. You decide to just trust […]
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 […]