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Pair These ICD-10 2018 Official Guideline Updates With Their Code Set Counterparts

18. August 2017

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The ICD-10-CM 2018 Official Guidelines are out and ready for review. When you check through the new OGs for changes, take special note of these updates that line up with 2018 code set revisions. Look at Level to Choose ‘In Remission’ Code When you start to apply new codes for substance abuse in remission (you’ll […]

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Transition and Flexibility Are the Buzzwords for QPP 2018 Proposed Rule

18. July 2017

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CMS released the proposed 2018 Quality Payment Program (QPP) rule on June 20. To sum up the 1,000+ pages, 2018 will be something of a transition year like 2017 was for QPP, which was established under MACRA. If you read through the various summaries available, you’ll see the term “flexibility” used quite often, with specialty […]

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Don’t Let EHR Tempt You to Upcode E/M Services

27. June 2017

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EHRs can assist with many aspects of E/M coding (like tracking for coding based on time), but the problem of reporting higher-level E/M codes without medical necessity is still around. A recent article in Ophthalmology Coding Alert discussed the example of a doctor who billed almost all level-four and level-five E/M codes for established patients. […]

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Don’t Get Too Comfortable With That Meaningful Use Payment – Here’s Why

20. June 2017

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When the title of an OIG report is about Medicare paying out hundreds of millions it shouldn’t have, that’s not great news for Medicare or the providers who got those funds. But that’s exactly what a report released June 12, 2017, says: “Medicare Paid Hundreds of Millions in Electronic Health Record Incentive Payments That Did […]

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3 Things You Can Do Today to Prepare for a RAC Audit

7. June 2017

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What’s the first think you think of when you hear Recovery Audit Contractor? RACs have been around for a while (and not without controversy) as part of a Medicare program to find and correct past improper payments. Even folks who don’t get nervous at the thought of an audit probably don’t look forward to the […]

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Step-by-Step Guide to Checking National Correct Coding Initiative Edits on SuperCoder

6. June 2017

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CCI Edits Checker is one of the tools SuperCoder subscribers use the most, so here’s a quick instructional guide to help users make the most of this resource, including the color-coded results and RVU options.   Note: This guide is specific to the CCI Edits Checker for Medicare PTP practitioner edits, but Outpatient Facility Coder […]

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Here’s What’s in Store for Medicare Advantage and Part D in 2018

23. May 2017

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Check out these bullet points for highlights from the 2018 Medicare Advantage and Part D payment and policy updates posted by CMS. Medicare Advantage Medicare Advantage (MA) plans, sometimes called Medicare Part C, are private plans approved by Medicare for people enrolled in Medicare. Medicare pays a fixed amount to the MA plan company, and […]

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4 Motivators for Sticking to the Coding Straight and Narrow

8. May 2017

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If you ever take the “throw everything out there and see what sticks” approach to coding, it’s time to rethink that strategy. Carefully choosing the wrong codes to bring in more money is no way to code either. Next time you need inspiration to steer clear of these methods, reach for these four reasons coding […]

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Secrets to Subsequent Hospital E/M Coding Success

2. May 2017

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Curious how your use of subsequent hospital visit codes compares to reporting by other practices? Palmetto was curious, too. The Part B MAC took part in developing a Comparative Billing Report (CBR) looking at 99231-99233 billing and payment patterns in 2015 for internal medicine providers. Motivation? Those codes see about a billion dollars in improper […]

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2 Costly Hip Coding Mistakes Corrected

18. April 2017

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With all the hippity hoppity talk this time of year, I have coding for hips on the brain. Might as well go with it and look into some hip coding tips! 1. Watch for Mod 22 Opportunities With Congenital Cases If your surgeon performs hip replacement surgery for a developmental or congenital hip dislocation, there’s […]

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