Hot Topic: Get the Scoop on Proposed MPFS 2019 Changes to E/M Coding and Payment

Fri, Aug 3, 2018


MPFS 2019 proposed rule

The 2019 proposed Medicare Physician Fee Schedule (MPFS) includes some major potential changes to E/M coding and payment in its 665 pages. Major. Here are the highlights. Just remember that what’s below is proposed and may change before the final rule is implemented.

Here’s the Big Payment News About Levels 2-5

Let’s get right to it. CMS wants to create a single set of RVUs for 99202-99205 (new patient office/outpatient E/M) and another single …

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ICD-10-CM 2019: Here’s What You Need to Know About Appendicitis, Screenings, and Blepharitis

Mon, Jul 30, 2018


ICD-10-CM 2019 implementation is just a couple of months away. The effective date, Oct. 1, 2018, is coming our way fast. Here are some interesting tidbits from our TCI Coding Alerts on the 2019 diagnosis code updates for appendicitis, screenings, and eye care to help you prepare.

Bonus tip: The 2019 ICD-10-CM Official Guidelines for Coding and Reporting are now available on the CDC site. Updates include the new rule allowing you to report …

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Did You Know? AHA Says Nonphysician Documentation Supports Z55-Z65

Thu, Jul 26, 2018


documentation of social determinants for ICD-10 coding

Reporting ICD-10-CM social information codes (Z55-Z65) based on documentation from nonphysicians is OK, according to official guidelines from the AHA. Before you change your approach to coding, here are the facts.

Locate the Original Coding Clinic® Q&A

In early 2018, AHA Coding Clinic® for ICD-10-CM and ICD-10-PCS (vol. 5, no. 1) published an answer to the question of whether you may use nonphysician documentation to assign codes that give information about social determinants of health. The example given was Z55-Z65 (Persons with potential health hazards related to socioeconomic and …

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3 Things to Know About Advanced Practice Providers in Your Practice

Fri, Jul 20, 2018


Advanced practice providers (APPs), sometimes known as non-physician practitioners (NPPs), are essential members of the healthcare team and serve a lot of roles. But, of course, “essential” doesn’t mean they’re always easy to code for. Make sure you keep these top pointers in mind when you’re completing claims for APPs, such as physician assistants, certified registered nurse anesthetists, and others.

1. Report APP Services Incident to a Physician’s Services for Higher Pay

When you’re talking about Medicare and payers that follow Medicare rules, you can expect APP services reported incident to a physician’s services generally to bring in 100 percent reimbursement. When reporting incident-to services, you bill using the supervising physician’s NPI rather than the APP’s NPI.

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Make Heart Failure Coding a Cinch With These Documentation Tips

Wed, Jul 18, 2018


ICD-10-CM coding for heart failure

Cardiology got off fairly light when it comes to 2019 ICD-10-CM changes, so that means you can devote some extra time and energy to refreshing your skills for your top diagnoses, like heart failure. One of the biggest problems experts report seeing in heart failure coding is that documentation supports coding only unspecified heart failure. Let’s look at the terms that will help lead to more specific codes for your acquired heart failure cases.

Zip to the Correct Heart Failure Code …

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Will You Ace This Gynecology Cervical-Health Coding Quiz?

Mon, Jul 16, 2018


Knowing uterine and cervical anatomy, and the difference between conization and biopsy will go a long way toward helping you with loop electrode excision procedure (LEEP) claims and other gynecology claims. This quiz helps give you a check up on terms and procedures.

Read the Questions Here

You’ve got two options for this quiz. If you want a harder version, read the questions in this section, and write down your answers. Don’t look at the next section, “Helpful Hint Option: Choose From These Possible Answers.” Then check your answers at the end.

If you want to choose from …

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3 Fast Tips to Improve Nerve Conduction Study Coding

Thu, Jul 12, 2018


nerve conduction study CPT coding

Clinicians use nerve conduction studies (NCS) to assess peripheral nerve function. Here are three pointers that are essential to accurate NCS coding.

1. Know Where to Find NCS Codes

Let’s start simple. You can’t report nerve conduction studies if you don’t know where to find the codes, so here they are. You choose the correct code based on the number of studies. (More on that in the next section.)

  • 95907 (Nerve conduction studies; 1-2 studies)
  • 95908 (… 3-4 studies)
  • 95909 (… 5-6 studies)
  • 95910 (… 7-8 studies)
  • 95911 (… 9-10 studies)
  • 95912 (<...
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Report Codes for Newborns? Bookmark This Maternal Drug List for Oct. 1, 2018

Mon, Jul 9, 2018


Opioid use has been getting a lot of attention lately, so it’s worth noting that ICD-10-CM 2019 is all set to include a code for a newborn affected by maternal use of opiates. That code was just one of ICD-10-CM 2019’s new additions in category P04.-. To help you find the right code faster when the codes are effective Oct. 1, 2018, you can use the alphabetical list below.

Tip: The list includes all 2019 ICD-10-CM codes in P04.-, not just changes, so you’ll have all the codes at your fingertips.

Find the Right Reportable Code in This Alphabetical List*

Codes in P04.- (Newborn affected by noxious substances transmitted via placenta or breast milk)

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35 Category III Code Updates Announced! Get to Know Them Fast

Thu, Jul 5, 2018


Four new Category III codes were effective July 1, 2018. But that’s just a warmup to the 35 changes planned for Jan. 1, 2019. Check this summary to see where you need to focus for updates.

Remember: The final list of codes may change before implementation, so be sure you use the final, correct list once the codes are effective.

What Codes Were Effective July 1?

You should already be using these codes for dates of service on and after July 1, 2018:

  • Code 0505T for endovenous femoral-popliteal stent placement “with crossing of the occlusive lesion in an extraluminal fashion”
  • Code 0506T for use …
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ICD-10-CM 2019: Add These Surgical Wound Infection Codes to Your Toolkit

Wed, Jun 27, 2018


surgical wound infection ICD-10 coding

If you read our ICD-10-CM 2019 overview, you know to expect new surgical wound infection codes effective Oct. 1, 2018. Get to know the notes with the codes to be sure you can match your documentation to these more specific 2019 diagnosis codes when the time comes.

Ob-Gyn Coders, Don’t Miss These Changes

The first set of new codes are under O86.0- (Infection of obstetric surgical wound). In the 2018 code set, O86.0 is a complete, reportable code. In 2019, you’ll need …

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