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Medicare has announced two updates to the Medicare Claims Processing Manual (MCPM). The implementation date is set for Aug. 27, 2019, but they’re effective all the way back to Jan. 1, 2019. If your physician performs home visits or superficial radiation treatment, you’ll want to be sure your knowledge is up to date. 1. Eliminate […]
Continue reading...Friday, March 15, 2019
Supervision and interpretation, contrast, and images — these are all terms you need to know for radiology CPT® coding. The 70000 Radiology section guidelines are a good place to start for authoritative information. Helpful: If you use a paper CPT® manual, you are likely to find the Radiology section guidelines directly preceding the first 70000 […]
Continue reading...Thursday, February 21, 2019
ICD-10-CM Official Guidelines state that your choice of diagnosis code is based on the provider’s diagnostic statement, but that’s not always as clear-cut as it sounds. Let’s dig in to this guideline. Work From the Official Guideline Wording The 2019 ICD-10-CM Official Guideline (OG) we’re discussing here is I.A.19: Code assignment and Clinical Criteria The […]
Continue reading...Thursday, January 24, 2019
The 2018 CERT report estimates 58 percent of Medicare improper payments were caused by insufficient documentation (and this is an ongoing trend). More than half is nothing to sneeze at, especially when you consider that those documentation problems could lead to having to repay Medicare or having to spend time working on underpayments. Here’s a […]
Continue reading...Thursday, December 20, 2018
We’ve been talking a lot about the 2019 Medicare Physician Fee Schedule final rule, but when there are changes to E/M rules, there can never be enough information, right? CMS recently released a response to a question that arose during a provider call about what parts of history ancillary staff or the beneficiary can document […]
Continue reading...Friday, June 22, 2018
ICD-10-CM 2019 is swapping the term “medial phalanx” to “middle phalanx” in 10 finger fracture codes. It’s a simple change, but it’s a reminder of the various factors involved in fracture coding. To help your orthopedic coding and documentation keep up with ICD-10-CM specificity, here’s a documentation checklist to help you find the right code […]
Continue reading...Wednesday, March 28, 2018
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 […]
Continue reading...Monday, February 5, 2018
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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Thursday, August 15, 2019
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