In CMS
Feb 8th, 2019
Under the “primary care exception,” a medical resident may perform (and bill for) limited, specific evaluation and management services without the presence of a teaching physician. Here’s what you need to know when reporting these resident services. When the Primary Care Exception Applies Ordinarily, services furnished by medical residents are excluded from Medicare payment because ...
In Coding
Feb 5th, 2019
Compare coding and billing for FQHCs to that of provider- and facility-based organizations. Federally qualified health centers (FQHCs) account for less than 10 percent of designated organizations, but as coding professionals we should understand the differences between FQHCs and physician- or facility-based organizations. Note: Medicare, Medicaid, and commercial carriers do not all process FQHC cla...
In Coding
Feb 5th, 2019
Don’t forget to review guideline changes while you familiarize yourself with 2019 code updates. For fiscal year 2019, we have 78,881 ICD-10-PCS codes to work with. Thankfully, there aren’t quite as many updates as last year: 392 new codes, eight revised codes, and 216 deleted codes. As usual, most of the code changes are in ...
Making the leap to the facility side of coding? Be sure you can decipher which diagnosis is principal. When transitioning from outpatient to inpatient coding, be sure you know the differences between the outpatient and inpatient guidelines when selecting principal and secondary diagnoses. Facility coders should be well versed in all four sections of the ...
This open and expandable procedural code set is nothing to be intimidated by. When outpatient coders talk about ICD-10, they typically mean the ICD-10-CM (diagnosis) code set. But there’s another ICD-10 code set: ICD-10-PCS. If you’re unfamiliar, here’s an introduction. PCS Describes Inpatient Procedures The ICD-10-PCS code set is used to code inpatient procedures; PCS ...