Nov 1st, 2014
When choosing codes, factor in age, time, CMS, CPT®, and bundling rules. by Holly Cassano, CPC Proper documentation and coding of critical care services depend not only on the Centers for Medicare & Medicaid Services (CMS) and CPT® guidelines, but also the payer (individual payers may have unique critical care requirements). To help ensure you ...
Aug 1st, 2014
Be sure the medical record carries enough voltage to bypass reimbursement challenges. Physicians often use computer-generated electrocardiogram (ECG) reports as the baseline for their own interpretation and report. Computer-generated ECG reports, alone, do not meet the requirements to code and bill for the professional component of an ECG. The Centers for Medicare & Medicaid Services ...
Oct 1st, 2012
By Holly J. Cassano, CPC Accurate payment under the Centers for Medicare & Medicaid Services (CMS) risk adjustment reimbursement model depends on diagnosis code specificity and reporting all current chronic conditions. A leading cause of incorrect and/or insufficient reimbursement from Medicare Advantage (MA) plans is deficient hierarchal condition categories (HCC) code reporting. CMS has been ...
Aug 1st, 2012
By Holly J. Cassano, CPC Proper hierarchal condition category (HCC) classification depends on a plan’s ability to obtain accurate diagnostic HCC information and report that information accurately to the Centers for Medicare & Medicaid Services (CMS). If a plan focuses solely on disease management to decrease costs (neglecting to develop an effective HCC strategy), it ...
Feb 1st, 2011
Don’t let the point-and-click mentality entice your time-pressed provider. By Holly J. Cassano, CPC Electronic health records (EHRs) promise to make the patient chart more inclusive, more legible, and faster to document. These advantages alleviate many of the headaches of paper charting. On the flip side—or the “dark side,” as I call it—the ease with ...