Part 2: Applying appropriate modifiers and assigning medically necessary diagnosis codes aids claim reimbursement. Delivering quality care while ensuring effective clinical documentation and compliant medical coding is an ongoing challenge in a fast-paced emergency department (ED). This two-part series reviews best practices for optimizing coding compliance and reimbursement of ED claims. Last mont...
In Billing
Jun 13th, 2018
Modifier 52, Reduced Services and Modifier 53, Discontinued Procedure apply to physician services while Modifiers 73 and 74, Discontinued Out-Patient Hospital/Ambulatory Surgery Center (ASC) Procedure Prior to the Administration of Anesthesia and Discontinued Out-Patient Hospital/Ambulatory Surgery Center (ASC) Procedure After Administration of Anesthesia respectively apply to facility charges. It ...
The 2018 CPT® code book introduces two new codes to report anesthesia during colonoscopy, one of which is applicable specifically for a screening exam. But if a screening colonoscopy reveals diagnostic findings, proper coding for the anesthesia service may differ, depending on the payer. CPT® Sticks with Screening Code 00812, Regardless of Findings CPT® 2018 deletes ...
In Billing
Jan 23rd, 2018
The codes that are considered a laboratory test under Clinical Laboratory Improvement Amendments (CLIA) change each year. These codes require a facility to have either a CLIA certificate of registration (type code 9), a CLIA certificate of compliance (type code 1), or a CLIA certificate of accreditation (type code 3). A facility with a CLIA ...
AAPC National Advisory Board Member Angie Clements CPC, CPC-I, CEMC, CGSC, COSC, CCS, helped bring clarity to three medical coding modifiers that are most problematic to physician practices. The three challenging modifiers include -59, -25, and -24. Clements advises coders to review documentation to ensure it supports the modifier. Read Clements’ tips on the Kareo blog. ...