In Billing
Aug 2nd, 2021
Get caught up on the medical coding and billing news that could affect payment for your professional claims. We cut out the rhetoric and give it to you plain and simple. OIG Audit Uncovers Overpayments for TCM Services If your physicians bill for transitional care management (TCM) services, it’s time for an internal audit of ...
In Billing
Aug 2nd, 2021
Correct coding and proper payment require strategy and teamwork. The preparticipation physical examination (PPE), or sports physical, is a valuable tool schools rely on to identify potentially life-threatening conditions as well as other issues that could pose a threat to a student’s health. This type of physical exam focuses on cardiovascular and musculoskeletal issues that ...
In Billing
Aug 2nd, 2021
Deciding which code to use starts with determining each payer’s policy. The Healthcare Common Procedure Coding System (HCPCS) has two principal subsystems, referred to as Level I and Level II. Knowing when to use HCPCS Level I codes versus HCPCS Level II codes can be confusing, mainly because many services are described by both code ...
In Coding
Aug 2nd, 2021
Put your diagnosis coding skills to the test with this ED patient encounter. CHIEF COMPLAINT: Chest pain HISTORY OF PRESENT ILLNESS: The patient is a 40-year-old male with a past medical history significant for hyperlipidemia and coronary artery disease who presents with a chief complaint of chest pain. He states that the chest pain started ...
In Billing
Aug 2nd, 2021
There are pros and cons to this final decision, and nobody is spared. The Centers for Medicare & Medicaid Services’ (CMS’) Inpatient Only (IPO) list is an inventory of procedures and services Medicare will pay for only when a beneficiary is admitted as a hospital inpatient. These procedures are typically surgeries that are labor- and ...