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 […]
Much attention is, rightly, going to the major overhaul of evaluation and management (E/M) office visit codes that will take effect in 2021 and is designed to reduce physicians’ documentation burden. But there are changes that have already taken effect Jan. 1, 2020, that acknowledge new ways of communicating with patients and practicing medicine that […]
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 […]
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 […]