When you can speak the language, correct reimbursement comes naturally. As healthcare business professionals, we’re expected to know the meaning of an infinite number of terms. It’s inevitable for some terms to be misinterpreted. For example, the terms “global service,” “global surgical package,” and “global period” often are used interchangeably, but they are distinct. To ...
It can mean the difference between getting paid for services and a hospital eating the cost. If you work in a teaching facility with residents, chances are you’ve had difficulty sorting through the Centers for Medicare & Medicaid Services (CMS) guidelines for proper billing of these services. Things start to make sense, however, if you ...
NGS is making certain exam requirements clearer. Under the current 1995 Documentation Guidelines for Evaluation and Management (E/M) Services, 2-7 body parts and/or organ systems are examined for both the expanded problem-focused visit and detailed physical exam visit. This contradictory guidance for determining level of service has frustrated many a provider and coder from day ...
UPDATE! Read the article “New Guidance Is Good News for E/M Service Coding” on page 54 of the May issue for new guidance that may help to make exam requirements clearer. They were problematic 20 years ago and are even more so with today’s technology. There are two sets of evaluation and management (E/M) services guidelines ...
Ambiguities in the 1995 documentation guidelines create uncertainty. Editor’s Note: After this article was written, a Medicare administrative contractor announced new definitions for “detailed” and “expanded poblem-focused.” See the May issue of Healthcare Business Monthly to learn more. Within the Centers for Medicare & Medicaid Services’ (CMS) 1995 Documentation Guidelines for Evaluation and ...