In Billing
Oct 19th, 2018
A beginner’s guide to claims code editing logic. The U.S. healthcare system is highly complicated and extremely expensive. There are many layers between the provider of medical services and the payment for those services. This overly complex system leads to inefficiencies resulting in incorrectly paid claims and the need to spend even more time and ...
Avoid payer denials by ensuring your provider or supplier follows the rules for allowable MUE units. Understanding why Medically Unlikely Edits (MUEs) were established, how they are organized, and the criteria on which edit rationales are based may help medical coders and billers avoid denials or, at a minimum, properly resolve a denial. What Are ...
Sep 11th, 2018
Scrubbing is the best way to ensure your claims are clean of unbundling overpayments. A hospital finance department should not treat National Correct Coding Initiative (NCCI) edits as irrelevant to inpatient billing simply because payers don’t use the NCCI to edit inpatient claims before payment. Instead, hospitals should institute internal controls to ensure claims are ...
In Coding
Jun 13th, 2018
Bone marrow aspiration and biopsy codes received updates in CPT® 2018 that significantly change how the services are reported. Existing codes 38220 and 38221 were revised: 38220 Bone Diagnostic bonemarrow; aspirationonly(s) 38221 Bone Diagnostic bonemarrow; biopsy, needle or trocar(ies) Note: To demonstrate the updates for 2018, new text is underlined and deleted text is struck ...
In Coding
May 3rd, 2018
The national Correct Coding Initiative (CCI) chapter guidelines are a great resource to find coding tips. To illustrate, here are three nuggets of coding knowledge found in just a single chapter (chapter 13) of the guidelines: Blood Draws from Venous Access or Catheter Only Separate for Lab Services Codes 36591 Collection of blood specimen from ...