Turning the microscope to critically examine the program you painstakingly created is no easy task. It is a challenging process that requires a fair amount of humility and humbleness. It’s hard to accept that your program, your staff, and you (the physician advisor) might suddenly not be as effective as you previously believed. Believe me, I speak from experience.
A recent Coding Clinic has garnered a lot of questions on inpatient obstetrics coding. While coders were originally taught to use multiple codes for the repair of a third- or fourth-degree perineal laceration, Coding Clinic , First Quarter 2016, states that you don’t use multiple codes for third- and fourth-degree tears, because you need to code to the “deepest layer.”
Podiatry coding can become complicated quickly, as a number of procedures can be performed on the same site or region of the foot. This means codes could easily run into NCCI edits or denials. One way to ensure physicians are reimbursed properly for provided services is to review NCCI edits pertaining to podiatry.
Q: What is the best way to document time spent by physicians performing procedures? The CPT® codes state a vague time amount but the doctors struggle with this.
CMS issued a change request to provide guidance to Medicare Administrative Contractors on the use of a new modifier to append to claims for dialysis treatments for end-stage renal disease exceeding the 13 or 14 monthly allowable treatments.
Traditionally, the OPPS rulemaking cycle has been the main vehicle for changes to outpatient coding and billing regulations and policy that hospitals need to pay attention to. But Jugna Shah, MPH , writes that, increasingly, CMS has been introducing or discussing changes relevant to outpatient hospitals beyond the scope of the OPPS rules.
Alcohol and Other Drug-Related Birth Defects Awareness Week began on Mother’s Day and aimed to raise awareness of the dangers of substance abuse during pregnancy. In honor of this awareness week, Yvette DeVay, MHA, CPC, CIC, CPC-I , discusses fetal alcohol syndrome disorders and ICD-10-CM coding for the condition.
James S. Kennedy, MD, CCS, CDIP, helps coders and CDI specialists process important aspects of Coding Clinic’s First Quarter 2017 guidance such as the sequencing of pneumonia in the setting of chronic obstructive pulmonary disease.
Adrienne Commeree, CPC, CPMA, CCS, CEMC, CPIP, writes about how understanding the different forms of viral hepatitis and alcoholic hepatitis, as well as their effects on the liver, help to clarify coding assignment. Note: To access this free article, make sure you first register here if you do not have a paid subscription.