In CMS
Sep 1st, 2012
The modifier is critical to telling the story of your medical coding claim. Just as words with similar definitions convey distinct meanings (“plan” versus “scheme,” for instance), so do modifiers with similar descriptors. We’ll discuss three that require precise application: modifiers 58, 78, and 79. Modifier 58 Modifier 58 Staged or related procedure or service by ...
Jun 1st, 2012
Fight for your right to be paid for properly documented claims. By G.J. Verhovshek When commenting on Abraham Morse’s, MD, MBA, article “Same-day E/M and Office Procedure: Yes, You Can!” (March 2012 Coding Edge, pages 16-17), several readers shared that insurers (including Medicare contractors) routinely deny evaluation and management (E/M) claims when reported with other ...
Oct 1st, 2011
Home health and monthly care services deserve reimbursement, but will require you to report care plan oversight correctly. By Kristine Cuddy, CPC, CIMC Coding for care plan oversight (CPO) often is overlooked. This is a mistake: CPO services deserve reimbursement, and coding and documentation requirements, although exacting, are worth the effort. Here are the guidelines ...
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 ...
Mar 1st, 2009
Five steps is all you need for modifier 25 claim success. By G. John Verhovshek, MA, CPC Misuse of modifier 25 Significant, separately identifiable evaluation and management service by the same physician on the same day of the procedure or other service is among the most common coding mistakes, costing medical practices millions each year ...