In Billing
Mar 19th, 2015
Modifier 24 Unrelated evaluation and management service by the same physician or other qualified health care professional during a postoperative period shows that the E/M being billed is not part of the global surgical package and therefore is separately reimbursable. To further indicate that the procedure is unrelated, it is recommended to assign a diagnosis ...
May 1st, 2012
Part 2: Make room for the latest in CPT® coding. By Marvel J. Hammer, RN, CPC, CCS-P, CHCO, ACS-PM, and G.J. Verhovshek, MA, CPC CPT® 2012 has brought important changes to pain management coding. Last month, in the article “Move Over Obsolete Pain Management Coding,” we reviewed new coding guidance for sacroiliac (SI) joint injection, ...
Dec 1st, 2011
Compliant coding is the best defense against falsified bills for personal injury suits. By Jeremy Reimer, CPC Bogus billing is a big problem in personal injury cases, and it’s getting worse. Unlike health insurance companies—which scrutinize every bill submitted for payment—auto insurance companies and self-insured carriers often have little recourse to dispute medical charges. To ...
May 1st, 2010
By LuAnn Jenkins, CPMA, CPC, CEMC, CFPC In 1992, the “global surgery” concept was introduced under the Resource Based Relative Value Unit System (RBRVS) and payment policy. Medicare adopted this method to control costs and to pay providers based on the value of services provided before, during, and after surgical procedures. Many commercial payers also ...
Apr 1st, 2010
By Peggy Stilley, CPC, CPC-I, COBGC, ACS-OB Are you new to obstetrics and gynecology (OB/GYN) coding? Do you wish you knew some helpful tidbits to ease daunting coding tasks? The following are scenarios most-commonly asked about by attendees during question-and-answer sessions while teaching OB/GYN. These “real world” examples can help you tackle day-to-day coding challenges ...