In Coding
Sep 3rd, 2019
CPT® code selection comes down to knowing what to look for in the note and asking the right questions. Fractures are common but coding them isn’t always easy. Correct coding relies on you knowing how to identify both the presentation and treatment of the fracture. To differentiate between the type of fracture and the type ...
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
Dec 20th, 2018
The National Correct Coding Initiative (NCCI) bundles evaluation and management (E/M) service and same day immunization administration (IA) codes, (e.g., CPT® 90460-90474). As a result, providers may face rejected claims when reporting an E/M service and same day immunization administration. The key to overcome these denials is to document precisely, and to append modifier 25 Significant, ...
In Billing
Sep 6th, 2018
The American Medical Association (AMA) sent a letter to the Centers for Medicare & Medicaid Services (CMS) Administrator Seema Verma on Aug. 27, 2018, with signatures from medical societies with comments on the CMS proposal for the Patients Over Paperwork initiative. AMA Loves Paperwork Reduction In the letter, the AMA says that they support CMS’ initiative ...
In Billing
Mar 1st, 2018
Anthem has sent a letter to the AMA to announce  they are rescinding the policy reducing payment for physicians when billing an E/M with a modifier 25 and a procedure that has zero or 10 global days. Anthem was planning on taking a 25 percent reduction on all 25 modified services billed with minor procedures as ...