In Billing
Jul 13th, 2018
There are times when a physician will be performing both covered and non-covered procedures at the same operative session. For example, the surgeon may be performing a septoplasty for a deviated septum (J34.2) and nasal obstruction (J34.89), which is a covered service. The patient wants to have a cosmetic rhinoplasty performed at the same time. ...
In Billing
Feb 8th, 2017
Time is an alternative option for E/M coding (on many, but not all, of the E/M codes) in lieu of the three key components, history, exam, and medical decision-making. Documentation Guidelines for Time According the Centers for Medicare & Medicaid Services (CMS), “In the case where counseling and/or coordination of care dominates (more than 50%) of ...
Mar 21st, 2013
When submitting medical claims, not only do you need to get the codes right but you have to apply the right rules. AAPC’s Director of Product Development Raemarie Jimenez, CPC, CPMA, CPPM, CPC-I, CANPC, CRHC, recently published an article in Physicians Practice that reviewed how the rules vary between code book guidelines, payer preferences, and ...
Mar 1st, 2013
By Ida Landry, MBA, CPC Knowing coding and billing rules, and following them with integrity, is key to success. Compliance is an important part of medical coding. Novice coders are instructed early on that “correct coding is the No. 1 objective,” and “if it isn’t documented, it wasn’t done.” These rules of thumb are the ...
In Billing
Aug 9th, 2012
The Centers for Medicare & Medicaid Services (CMS) issued, Aug. 1, a final rule for 2013 payment policies for inpatient stays at general acute care and long-term care hospitals (LTCH). The new rule includes elements of the Affordable Care Act (ACA) hospital value-based purchasing and hospital re-admissions reduction programs. The rule also includes new efforts ...