In Audit
Nov 27th, 2019
Consistent with previous reporting, the Office of Inspector General (OIG) has added to its 2020 Work Plan a targeted audit of Medicare Advantage (MA) programs for risk adjustment diagnosis codes. This is not the first time federal agency has targeted risk adjustment data. The OIG stated back in 2017, “We will review the medical record ...
In Billing
Nov 25th, 2019
Three new HCPCS Level II G codes are added to the Medicare Telehealth Services list for Calendar Year (CY) 2020. These codes describe new bundled services for the treatment of opioid use disorders (OUD). The Centers for Medicare & Medicaid Services (CMS) states in the 2020 Physician Fee Schedule final rule, “By creating a separate ...
In Billing
Nov 7th, 2019
Changes to diagnosis codes mean NCD coding changes. Diagnosis codes changes went into effect Oct. 1, as usual, and the Centers for Medicare & Medicaid Services (CMS) is updating National Coverage Determinations (NCDs) to reflect those changes. NCDs Affected by Updates to Diagnosis Codes CMS notes the following NCD coding changes in Change Request (CR) ...
In Coding
Oct 9th, 2019
Part 2: Strengthen your ICD-10-PCS coding for lumbar spinal fusion procedures. Coding spinal fusion in an outpatient or ambulatory surgery center (ASC) setting with CPT® is very different than coding spinal fusion in the inpatient setting with ICD-10-PCS. For example, as illustrated in Figure 1, CPT® divides the spine into three columns: Anterior (anterior two-thirds ...
In Coding
Oct 9th, 2019
Prevalence and risk require targeted diagnostic testing. Onychomycosis (tinea unguium), or fungal infection of the nail, causes almost half of all nail pathologies worldwide. It is a progressive infection of the nail characterized by thickening with degrees of white to yellow-brown discoloration and separation of the nail from the nail bed. Here’s why molecular testing ...