In CMS
Jan 18th, 2019
There has been ongoing debate about how to code complex repairs versus tissue transfers and rearrangements. Correct coding requires an understanding of the two surgical approaches. In the latest update to the National Correct Coding Initiative (NCCI) Policy Manual for Medicare Services, the Centers for Medicare & Medicaid Services (CMS) clarifies its definition of these ...
In Billing
Apr 3rd, 2018
Here’s a question to consider when coding and billing for services performed as part of an accountable care organization (ACO):  who pays providers’ standing claims if the ACO dies? If the State of Utah has its way, seven payers will have to pony up $26.6 million in unpaid claims for the Arches Health Plan, which folded ...
In Billing
Dec 2nd, 2013
Tissue adhesives, such as Dermabond®, may be used alone or in combination with other methods (e.g., sutures or staples) for laceration repair or to close surgical wounds. The adhesive is applied directly to the skin or tissue of an open wound to hold the margins closed for healing. Proper coding for tissue adhesives has changed ...
In CMS
Nov 1st, 2013
Find three important details in the wound repair report, and you’ve got the case all sewn up. by G.J. Verhovshek, MA, CPC When coding for wound repair (closure), you must search the clinical documentation to determine three things: The complexity of the repair (simple, intermediate, or complex) The anatomic location of the wounds closed The ...
Oct 1st, 2012
By Wendy Grant, CPC There is no quick way to code an operative (op) report. You must read and reread—think dissection—to be sure your coding reflects all the procedures and diagnoses performed. Code from the Body of the Report To code only the “preoperative diagnosis, postoperative diagnosis, and operation performed,” listed at the beginning of ...