Seven coding challenges reveal a new compliance landscape in 2020. It’s here: 2020! This past year in healthcare, as in many years before, was full of changes, challenges, and some surprises as well. When trying to foresee the key future challenges in clinical coding, the following topics came to mind for me. Severe Sepsis We […]
With an election year just about upon us, there are a number of changes coming from the current administration that are going to impact healthcare in 2020. Changes in allowable benefits, home health, hospice carve-ins, and new CPT codes for remote home monitoring are just a sample of these. There are an additional set of fundamental […]
The Centers for Medicare and Medicaid Services has taken steps to overhaul codes used for Evaluation and Management (EM) office visit codes. The initiative aims to reduce documentation burdens that interfere with patient care, the American Medical Association says. The professional organization for the nation’s physicians is providing a series of educational materials to support […]
Q: There seems to be a trend of practices using a variety of staff as ‘educators’ to provide patient education. The more recent ‘twist’ is the billing of E&M codes for non-physician providers, based in either clinical documentation or time-based, under the ‘incident to” provision – even though the physician does not see the patient for these […]
The coding of medical diagnosis and treatment has always been a challenging issue. Translating a patient’s complex symptoms, and a clinician’s efforts to address them, into a clear and unambiguous classification code was difficult even in simpler times. Now, however, hospitals and health insurance companies want very detailed information on what was wrong with a […]
Physicians, paramedics and other healthcare professionals are accustomed to treating medical conditions. But they are also increasingly part of efforts to end human trafficking, according to The Washington Post. According to the United Nations’ International Labor Organization, an estimated 40.3 million people worldwide were being forced to work against their will under threat or living in a forced marriage in 2016. […]
Consider anatomy and coding guidance to put things into perspective. Functional endoscopic sinus surgery (FESS) is a surgical procedure performed endoscopically on the nasal/sinus cavities. The purpose of the surgery is to reduce the symptoms of chronic sinusitis such as congestion, drainage, post-nasal drip, headaches, and facial pain. FESS Coding can be unnerving because there […]
Consideration of several factors, such as the type of removal, lesion size and location, pathologic results, intent, etc., is key to accurately coding dermatological lesion removal procedures. Let’s review the codes and guidelines for lesion removal by excision and how to avoid common mistakes when coding these skin procedures. Excision – Benign/Malignant Lesions (11400-11646) Excision […]
Q: Some of our Medicare patient’s complain about their $20 or so co-pay when we bill ‘Combination visits’, a G0439 Annual Wellness visit codes(AWV) and another Current Procedural Terminology (CPT) code for managing their problems during the same visit. Is there a good solution to this issue or any advice to maybe remedy this? A: This […]
The American Medical Association issued a checklist for the transition to fundamental changes in evaluation and management (E/M) services, a medical coding process in support of medical billing which practicing healthcare providers must use to be reimbursed by Medicare, Medicaid programs or private insurance. The checklist provides a guide for physician practices, which already are […]