The amount of energy it takes to stay up to date on all the relevant payment and coding updates can be overwhelming, taking valuable time away from daily record review duties and activities.
Did you know there is a coding competition? The second annual ICD-10 Coding Contest, sponsored by Central Learning, took place last summer, recruiting coders from all over the nation to participate in coding a total of 1,636 real-life medical cases.
Review the provider documentation and operative report and consider the ICD-10-CM and ICD-10-PCS codes to be reported. See the answers and rationale to check your answers.
In the current healthcare climate, the issue of medical necessity documentation, or lack thereof, is one of the most common reasons for claim denials. For a service to be considered medically necessary (by a third-party payer), it must be considered a reasonable and necessary service to diagnose and/or treat a patient’s current and/or chronic medical condition.
One of the most memorable sessions at the AMA CPT Symposium in November 2017 involved an impromptu open mic feedback session facilitated by CMS’ Marge Watchorn, deputy director of the Division of Practitioner Services. The focus of this session was the applicability of the current CMS documentation guidelines for E/M services.
In the 2018 OPPS final rule, CMS finalized a change to the current clinical laboratory date of service policies for outpatient molecular pathology tests and advanced diagnostic laboratory tests.
The skin is the largest organ in the human body and plays a vital role in protecting the body from injury and illness. This article reviews integumentary anatomy and provides guidance to aid in accurate ICD-10-CM and CPT code assignment for complex integumentary diagnoses and procedures. Note : To access this free article, make sure you first register here if you do not have a paid subscription.
The World Health Organization is preparing for the official release of the 11th Revision of the International Classification of Diseases, or ICD-11, in June.
Bundled Payments for Care Improvement Advanced, a new voluntary bundled payment model launched by CMS in January, includes 32 clinical episodes encompassing both inpatient admissions and outpatient procedures. Yvette DeVay, MHA, CPC, CPMA, CIC, CPC-I , writes about participation criteria, payment calculations, and quality measures for this program.
