Tag: ICD-10-CM Codes

Medical-Necessity-Denials-Image

How to avoid medical necessity denials

How to avoid medical necessity denials and ensure timely payment. Sick visit on the same day as an annual wellness visit (AWV) Reason for denial: Lack of clear clinical documentation regarding why the physician had to go above and beyond what is normally addressed during an AWV. How to avoid it:“I often tell doctors to […]
Learn More
selecting-the-principal-diagnosis-lies-at-the-heart-of-inpatient-coding

Selecting the Principal Diagnosis Lies at the Heart of Inpatient Coding

The heart of the principal diagnosis selection is pivotal to accuracy and compliance. Since February is known as “National Heart Month,” a discussion on the heart of inpatient coding is appropriate, that being the “principal diagnosis.” When learning inpatient coding, a large amount of time is spent on understanding the guidelines, conventions, and application of […]
Learn More
when-to-report-an-incidental-finding

When To Report an Incidental Finding

DOJ lawsuits may be your road map to risk adjustment compliance. The growing prevalence of risk adjustment in healthcare has forged new processes in documentation practices that have resulted in many organizations adopting practices that bend the cast iron rules for ICD-10-CM coding. We are starting to see some of the long-term dangers of ambitiously […]
Learn More
take-5-get-caught-up-on-coding-and-billing-news

Get Caught Up on Coding and Billing News

New COVID-19 vaccine status codes, changes and corrections to the 2022 CPT code set, Medicare Physician Fee Schedule (MPFS) payment changes, and prior authorization code list changes — that’s what’s on the agenda this month. Read all about it! 3 New Codes Improve COVID-19 Vaccination Status An April 1, 2022, update to the 2022 ICD-10-CM […]
Learn More
new-covid-19-icd-10-cm-and-pcs-codes-coming-in-2022

New COVID-19 ICD-10-CM and PCS Codes Coming in 2022

  The package includes three ICD-10-CM and seven procedure codes. The Centers for Disease Control and Prevention (CDC) and the Centers for Medicare & Medicaid Services (CMS) have both stated that in April 2022, we will have three new ICD-10-CM codes and seven new procedure codes for COVID-19 therapeutics and vaccines. You may recall that […]
Learn More
resolve-initial-vs-subsequent-encounter-misconceptions

Resolve Initial vs. Subsequent Encounter Misconceptions

End the sequela struggle for when to include a 7th character with this primer. ICD-10-CM codes aren’t just for coding; they’re also used for payments, statistics, and other health information management activities. Therefore, some codes are designed to meet certain episode of care requirements that translate into costs. For example, a code describing an acute […]
Learn More
reporting-covid-19-vaccination-status-in-2022

Reporting COVID-19 Vaccination Status in 2022

Three new diagnosis codes for reporting COVID-19 vaccination status will go into effect April 1, 2022. The codes were presented by the National Center for Health Statistics (NCHS) at the Sept. 14-15, ICD-10 Coordination and Maintenance Committee meeting, so they are not listed in the 2022 ICD-10-CM code book. The new ICD-10-CM codes for reporting […]
Learn More
gain-insight-into-billing-an-e-m-with-omt

Gain Insight Into Billing an E/M With OMT

Reducing denials starts with understanding osteopathic manipulation as well as coding and coverage guidelines for this therapy. Is it appropriate to bill an evaluation and management (E/M) service when osteopathic manipulative treatment (OMT) is performed at the same visit? We must address a few key principles to adequately answer this question. I learned quickly, having […]
Learn More
many-final-ipps-rules-are-released

Many Final IPPS Rules Are Released

While much attention has been focused on the release of the IPPS Final Rule, other final rules might have gone unnoticed. The Centers for Medicare & Medicaid Services (CMS) were very busy the first week of August, with the release of final rules for skilled nursing facilities (SNFs), hospices, inpatient rehabilitation facilities (IRFs), and inpatient […]
Learn More
x