In Audit
Aug 1st, 2019
Rik Salomon, CPC, CRC, CEDC, CEMA, CMCS, and I recently got into a rather spirited debate with a group of Certified Professional Coders (CPCs®) on coding guidelines and how they govern our medical coding. CPT® and ICD-10 guidelines are the primary determinants for how we code. We ignore all rules from Medicare and other payers ...
Jul 29th, 2019
Payer-specific rules — especially rules that vary for every claim — not only make collecting revenue difficult, but also add to the cost of collection of monies earned by the physicians. A blog clarifies Novitas’ instructions for reporting modifier 50 when bilateral procedures are performed. The instructions from Novitas state that bilateral services should be ...
In Coding
Jun 10th, 2019
Providers no longer need to link documentation to diabetes mellitus for certain related conditions for coding; it’s implied. Medicare risk adjustment (MRA) coders identify active diagnoses that determine a patient’s level of risk (the likelihood of that patient needing medical care). This helps health plans project the cost of caring for their patient population. That ...
In Coding
May 7th, 2019
Excludes 1 and 2 notes often hold the key to preventing claims denials. There are two type of excludes notes in the ICD-10-CM classification system: Excludes 1 and Excludes 2. Medical coders need to understand the meaning of these notes because they are integral to correct coding, and payers are beginning to deny claims based ...
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 ...