Category Archives: Coding & Billing
The ABCs of Coding
Imagine trying to have a conversation with someone who only speaks a foreign language and having no access to a translator. Tough to do, right? You’d need basic use and understanding of relevant words in the foreign language and your … Read Full Post
What We’re Reading – New coding guidelines a recipe for improved revenue
As we close the first week of the new E/M coding guidelines – assuming your brain spasms are resolving – you might be wondering how the changes line up to payments. Are you better or worse off under the new … Read Full Post
MRA & The New Patient Visit
In our years of reviewing charts, we’ve observed new PCP visits where the clinician assigns diagnoses based on the medications the patient is taking, adds them to the problem list and includes them in the assessment of the visit. Let’s … Read Full Post
WWR – Kaiser agrees to pay $6.4 million to settle claims it received inflated Medicare Advantage payments
Kaiser joins the undignified ranks of the companies investigated for committing fraud. This timely article from Healthcare Finance News doesn’t use that word, but it describes the finding that Kaiser “knowingly submitted” false diagnoses to inflate its payments, which is … Read Full Post
E/M Codes Are A-Changin’ for 2021
Evaluation & Management codes, which have long been the bane of physicians and billers, determine the payment for the most common outpatient medical services. Each E/M code level corresponds to an expected fee, and historically, code selection has depended on … Read Full Post
CMS Added 11 New Telehealth Services
Effective October 14, 2020, CMS added 11 new services to its list of approved telehealth codes, which include cardiac and pulmonary rehabilitation. This handy list contains all the telehealth services, the dates on which they were approved and whether they … Read Full Post
What We’re Reading – CMS Announces the Resumption of Medicare Audits
In a previous post, we announced that CMS would be resuming program integrity audits in August. This recent article explained some additional details of their “short-lived hiatus.” Despite the continuing public health emergency (PHE), CMS did resume on August 3rd … Read Full Post
Chronic Kidney Disease Stage 3
For 2021 coding, which begins on October 1, 2020, Chronic Kidney Disease Stage 3 (N18.3) was changed to N18.30 Chronic Kidney Disease Stage 3, unspecified (This code corresponds to Glomerular Filtration Rates (GFRs) between 30 and 59.) N18.31 Chronic Kidney … Read Full Post
Did You Know…Medicare Pays for Depression Screenings?
According to the National Institutes of Mental Health, depression is one of the most common mental disorders in the U.S. It can begin at any age, often in adulthood, and can occur with other serous medical conditions. Research indicates that … Read Full Post
Compliance Tool-kit Should Include External Validation
Although all providers should have a Compliance Program, it seems that mostly larger groups have them in place and even then, to varying degrees. Many practices have some form of internal validation of a coder’s work; most of the time, … Read Full Post