Look at diagnosis history changes and Medicare’s national and local coverage determinations for greater insight into denied claims. Coverage determinations for hyperbaric oxygen therapy (HBOT) for radiation proctitis make getting paid for physician services tricky. A review of historical diagnosis code changes, and the effect these changes have had on Medicare coverage determinations is necessary ...
In Coding
Aug 6th, 2019
Alert coders of Excludes1 conflicts to help you catch problems in problem lists and avoid costly denials and rework. By Rebecca Caux-Harry, CPC In April’s Healthcare Business Monthly (pages 56-57), in the article “Take the Problem Out of Problem Lists,” authors Mary Wood, CPC, CPC-I, and Michael Warner, DO, CPC, CPCO, CPMA, AAPC Fellow, include ...
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 ...
In Coding
Jul 31st, 2019
The pesky illness can be diagnosed properly by knowing the signs and symptoms and detecting it with pathology. Lyme disease is a common vector-borne illness in the United States, with more than 300,000 cases each year, according to the Centers for Disease Control and Prevention (CDC). The most prevalent areas for outbreaks are in the ...
In Billing
Jul 25th, 2019
Effective Oct. 1, 2019, ophthalmology coders will be able to report orbital roof and wall fractures with the utmost of specificity thanks to the creation of several new ICD-10-CM codes. Lack of Specificity Presents a Problem Presently, there is only one diagnosis code, S02.3- Fracture of orbital floor, to report orbital bone fractures, and only ...