Tag Archive | "E/M"

Emergency Medicine Coders: Don’t Miss These 3 Trending Areas!

Wednesday, March 28, 2018

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There have been some hot topics in recent issues of TCI’s Emergency Department Coding & Reimbursement Alert that are just too good not to share. Here’s a quick summary with links to the articles for you lucky readers with access to the online newsletter or to Emergency Medicine Coder. 1. Streamline With This Change to […]

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Knock Out 99285 Confusion Now – This ED Code Is Getting Noticed

Friday, February 16, 2018

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The highest level emergency department code, 99285, is popular. A comparative billing report (CBR) by eGlobalTech recently showed the national percentage of emergency department services submitted with 99285 was 55 percent. And when the highest level E/M code in a group is getting that much use, you know there’s going to be some scrutiny. Here’s […]

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$36.2 Billion in Improper Payments Means CMS Will Watch These Areas

Monday, February 5, 2018

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A 90.5 percent accuracy rate for Medicare Fee-for-Service (FFS) payments may not sound too bad, but consider that the 9.5 percent improper payment rate adds up to $36.2 billion! That’s the news from the 2017 Medicare Fee-for-Service Supplemental Improper Payment Data report based on Comprehensive Error Rate Testing (CERT). Smart move: Reviewing CERT results can […]

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Can’t-Miss Corrections to CPT® 2018 Available Now!

Monday, December 4, 2017

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Time to bring out the red pen and take your CPT® 2018 preparations to the next level! Every detail counts in coding, and that means that after you’ve taken a look at the initial announcements about code changes, you need to dig deeper to make sure you’re aware of corrections, too. The AMA released several […]

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5 Fast Facts About 1 Payer’s 50 Percent Fee Reduction for Modifier 25

Monday, November 6, 2017

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A payer’s big modifier 25 payment reduction has been getting a lot of attention, both from providers affected and those concerned other payers will adopt the policy. Don’t miss this overview of what the policy is all about. 1. Which Payer Implemented the Policy? Independence Blue Cross, which primarily serves Philadelphia and southeastern Pennsylvania, updated […]

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Ups and Downs, MACRA Modifiers, and E/M DGs in MPFS 2018 Proposed Rule

Tuesday, July 25, 2017

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Part 3 of our proposed rule extravaganza is about the Medicare Physician Fee Schedule (MPFS) 2018 proposed rule. (Part 1 was QPP and Part 2 was OPPS). Let’s get down to business, checking out some highlights explained in recent issues of Medicare Compliance and Reimbursement. Plusses and Minuses The proposed 2018 conversion factor is 35.99, […]

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

Tuesday, June 27, 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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Secrets to Subsequent Hospital E/M Coding Success

Tuesday, May 2, 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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Welcome Spring With 3 Laceration Coding Scenarios

Monday, April 10, 2017

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The weather is getting warm enough for bare feet, knees, and elbows, and that leaves them more vulnerable to lacerations. Check out these three scenarios to help you choose correct codes for those cuts, powering up your laceration coding skills for spring. Case 1: Don’t Overcode for Bandaging Skinned Knee Suppose an established patient presents […]

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Tighten Up Your Documentation for Coding E/M Based on Time

Monday, November 21, 2016

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If you almost always choose your E/M codes based on history, exam, and medical decision making (HEM), you may be hesitant to code based on time. But ignoring this opportunity could be leading you to report lower level E/M codes that reimburse at a lower rate than you deserve. Take your time-based coding confidence up […]

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