In Coding
Aug 2nd, 2016
Hypertensive heart disease refers to a group of disorders that includes heart failure, ischemic heart disease, and left ventricular hypertrophy. It is the number one cause of death associated with high blood pressure. Documentation must state (heart failure due to hypertension) or imply a causal relationship (hypertensive heart failure) to assign a code from category ...
In Coding
Apr 4th, 2014
If your practice sees patients with documented nonreversible symptomatic bradycardia, you should know that the Centers for Medicare & Medicaid Services (CMS) recently established a national coverage determination (NCD) allowing payment for implanted permanent cardiac single- or dual-chamber pacemakers, used for the treatment of this disease. Coverage is effective for claims with dates of servic...
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 ...
Aug 1st, 2012
By Serine A. Haugsness, CPC The concept of risk adjustment was “born” upon passage of the Balanced Budget Act of 1997 and refined by the Beneficiary Improvement Act of 2000, which mandated that the Centers for Medicare & Medicaid Services (CMS) implement risk adjustment for Medicare Advantage organizations (MAOs) in 2004 and achieve 100 percent ...
Apr 1st, 2008
Here’s What to Do … By Nancy Reading RN, BS, CPC, CPC-I A member recently inquired, “Where can I safely count clubbing of the fingers on physical examination?” This question begs an issue that faces coders every day. We think we know the answer because that’s how we always do it, or that is how ...