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JustCoding.com
Issue 2, September 2, 2009
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New on JustCoding Platinum!
New on JustCoding Platinum! -
Know the differences between packaged versus bundled services
Staff members still trying to understand the differences between packaged and bundled services now... -
Understand the link between diagnostic podiatry coding and coverage for DME, MRIs, and ultrasounds
Accurate diagnosis coding for podiatry affects coverage and reimbursement for some durable medical... -
Establish an audit team at your physician practice to address common compliance problems
Sharon Bolarakis, CPC, CPC-I, explains the important role an audit team can play at your physician... -
Healthcare News: OIG urges CMS to revise incident-to policies
In an August report titled “Prevalence and Qualifications of Nonphysicians Who Performed... -
Q&A: Reporting procedures during the global surgery period for a septoplasty or submucous resection
QUESTION: I work for an allergy, ear, nose, and throat clinic and am questioning a recent encounter... -
Product of the week
Product of the week -
Trivia winner
Trivia winner -
Coder chat
Coder chat -
Quote of the week
Quote of the week -
Mini-poll
Mini-poll -
Last week's mini-poll
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Quizlet
Quizlet
Issue 2, August 26, 2009
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New on JustCoding Platinum!
New on JustCoding Platinum! -
Audit Checklist: Incident-To Services
Elin Baklid-Kunz, MBA, CPC, CCS, the director of physician services for Halifax Health in Daytona... -
Take into account the effects of code assignment on overall data quality and possible risk adjustments
Coding is a mechanism for reimbursement as well as the basis for administrative data collection, as... -
Round-up of recent RAC developments: Connolly and HealthDataInsights announce issues for review
Two Recovery Audit Contractors (RAC) recently announced issues for review in Florida, South... -
Improve documentation with strong CDI specialist, program
More hospitals will likely develop clinical documentation improvement (CDI) programs as ICD-10... -
Healthcare News: CMS confirms noncoverage of CTC for colorectal cancer
On August 7, CMS issued Transmittal 105 in the Medicare National Coverage Determinations Manual to... -
Q&A: Coding acute blood loss anemia due to patient noncompliance
QUESTION: A patient undergoes outpatient surgery and is subsequently admitted due to acute blood... -
Product of the week
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Trivia question
Trivia question -
Coder chat
Coder chat -
Quote of the week
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Mini-poll -
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Quizlet
Quizlet
Issue 2, August 19, 2009
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RAC E-blast
RAC E-blast -
New on JustCoding Platinum!
New on JustCoding Platinum! -
Chapter 7: Continuous Survey Readiness
This excerpt from HCPro’s book, Information Management and Record of Care, Treatment, and... -
Look to CMS, AHIMA for E/M leveling guidance
To successfully code evaluation and management (E/M) outpatient visits, coders need an effective... -
CMS highlights 12 steps for ICD-10 implementation at physician practices
For physician practice coders, the transition to ICD-10 in 2013 might not be as bad as one might... -
Q&As address rules for reporting modifiers -25, -54, and -74
Understanding when to report certain modifiers often presents murky dilemmas for coders. Modifiers... -
Healthcare News: AMA clarifies appropriate reporting for H1N1 vaccine code
The American Medical Association (AMA) issued a clarification regarding the appropriate method of... -
Q&A: Rules for reporting E/M services with other procedures performed during the same visit
QUESTION: A patient presents for treatment of a new problem—bumps on his or her skin. A... -
Product of the week
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Trivia winner
Trivia winner -
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Issue 2, August 12, 2009
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New on JustCoding Platinum!
New on JustCoding Platinum! -
Uncover this helpful GEM to assist with ICD-10 transition
Despite the fact that ICD-10 implementation is nearly three years away, CMS is ramping up its... -
Explore potential principal diagnoses for patients admitted after falls
In the second part of this two-part series, Joel Moorhead, MD, PhD, discusses the details of... -
Coders need specific details before coding anemia secondary to chemotherapy
Coding for anemia can be challenging for coders because physician documentation regarding its... -
Cancer
Cancer -
Hypertension
Hypertension -
Plantar fasciitis
Plantar fasciitis -
Healthcare News: CMS clarifies appropriate use of modifier -50 and add-on codes for facet joint injection services
On July 31, CMS issued Transmittal 526 in the One-Time Notification Manual, which states that when... -
Q&A: Coding a diabetic abscess of the breast
QUESTION: A patient presents with breast pain and is diagnosed with a diabetic abscess of the... -
Product of the week
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Trivia question
Trivia question -
Coder chat
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Issue 2, August 5, 2009
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IPPS Final Rule E-blast
IPPS Final Rule E-blast -
New on JustCoding Platinum!
New on JustCoding Platinum! -
Audit Checklist: Critical Care Services
Elin Baklid-Kunz, MBA, CPC, CCS, the director of physician services for Halifax Health in Daytona... -
HIPAA 5010: Take this necessary first step toward ICD-10 implementation
By now, most hospitals know of the impending October 2013 implementation deadline for ICD-10. What... -
Don't stumble when assigning the principal diagnosis for falls
In this first article of a two-part series, Joel Moorhead, MD, PhD, discusses the coding challenges... -
Consider these tips when selecting an EMR for your practice
Many physicians are currently focusing on electronic medical records (EMR) and how they can qualify... -
Healthcare News: CMS releases FY 2010 Inpatient Prospective Payment System final rule
Acute care hospitals will receive a 2.1% increase in their payment rate rather than a 1.9... -
Q&A: Coding for a fish hook removal
QUESTION: Each summer, questions arise regarding how to code a fish hook removal. The emergency... -
Product of the week
Product of the week -
Trivia winner
Trivia winner -
Coder chat
Coder chat -
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Mini-poll -
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Issue 2, July 29, 2009
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New on JustCoding Platinum!
New on JustCoding Platinum! -
Raise your awareness of overcoding, and learn pitfalls of overdocumentation
Although undercoding is always a concern for facilities, potential overcoding is just as serious a... -
An auditor's view of the top five evaluation and management documentation challenges
Periodic evaluation and management audits—whether performed internally or by an outside... -
New ICD-9-CM codes for fiscal year 2010 reflect shift toward increased specificity
Shannon E. McCall, RHIA, CCS, CCS-P, CPC-I, and Robert S. Gold, MD, discuss the outpatient... -
Healthcare News: CMS launches Web site to provide resources about HIPAA Version 5010
On July 17, CMS launched a Web site that includes information about HIPAA transaction standard... -
Q&A: Coding for a CT triple rule-out study
QUESTION: How should we code a computed tomography (CT) triple rule-out study? A provider performs... -
Product of the week
Product of the week -
Trivia question
Trivia question -
Coder chat
Coder chat -
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Quote of the week -
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Mini-poll -
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Issue 2, July 22, 2009
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New on JustCoding Platinum!
New on JustCoding Platinum! -
Present on Admission: Accurate Reporting to Ensure Appropriate Reimbursement
In this new white paper, Shannon McCall, RHIA, CCS, CCS-P, CPC, CPC-I, CCDS, director of coding and... -
Demand a code for demand myocardial infarction
Robert S. Gold, MD, explains his concern with the pervasive use of the term “acute coronary... -
Study spinal anatomy to reinforce appropriate code assignment for pain management procedures
Lois E. Mazza, CPC, PCA, discusses the anatomy of the spine and vertebrae, and the codes for some... -
Review seven coding tips for teaching hospitals
Teaching hospitals receive additional reimbursement from the government for training residents, and... -
Healthcare News: AMA announces CPT code updates
The American Medical Association (AMA) updated Category I vaccine codes, Category II codes... -
Q&A: Coding for the removal of an infected dialysis graft
QUESTION: We received a denial for an inpatient claim that included the removal of an infected... -
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Trivia winner -
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Coder chat -
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Mini-poll -
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Last week's mini-poll -
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Issue 2, July 15, 2009
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New on JustCoding Platinum!
New on JustCoding Platinum! -
Medical Records Documentation Audit Tool--Physician Office
Jean S. Clark, RHIA, CSHA, shares this audit tool, which you can use as a guide to documentation in... -
Make your case for CDI in fiscal year 2010 and beyond
If you haven’t implemented a clinical documentation improvement (CDI) program yet, the... -
Clinical examples help illustrate when it's appropriate to report modifiers -79 and -24
Using case studies, Debra Ingersol, CPC, CCS-P, explains when it’s appropriate to report... -
Code presenting signs and symptoms to support medical necessity in the ED
During an emergency, physicians may perform procedures or tests necessary to rule out other... -
Healthcare News: Note new code for H1N1 virus and revised code for avian influenza
The National Center for Health Statistics addenda for 2010 ICD-9-CM includes an expanded code... -
Q&A: Understanding NCCI edits for bundled CPT codes
QUESTION: I am trying to understand the terminology for ‘0,’ ‘1,’ and... -
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Trivia question -
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Issue 2, July 8, 2009
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New on JustCoding Platinum!
New on JustCoding Platinum! -
Set the bar with outpatient coding productivity standards: Get started with these six questions
Establishing coding productivity standards is a necessary and challenging part of running an... -
Craft a comprehensive policy to help foster consistent and compliant queries
A query policy should address the specific needs of the hospital, but it’s just as important... -
Ensure accurate pain management code assignment: Review anatomy, common injections, and procedures
Stephanie Ellis, RN, CPC, discusses the most common pain management procedures as well as... -
Healthcare News: CMS releases 2010 OPPS proposed rule and proposed Medicare Physician Fee Schedule
On July 1, CMS released the outpatient prospective payment system (OPPS) proposed rule for 2010 as... -
Outpatient Coding Productivity
Outpatient Coding Productivity Table -
Q&A: Reporting services that occur during the postoperative global period
QUESTION: A patient undergoes a breast biopsy (CPT code 19101, Biopsy of breast; open, incisional... -
OPPS
OPPS proposed rule -
History of Present Illness Reference Tool
Use this sample reference tool to determine the chronological development of a patient's current... -
Product of the week
Product of the week -
Trivia winner
Trivia winner -
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Coder chat -
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Quote of the week -
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Mini-poll -
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Issue 2, July 1, 2009
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New on JustCoding Platinum!
New on JustCoding Platinum! -
Sequence codes properly for appropriate DRG assignment
Robert S. Gold, MD, illustrates the importance of reporting codes in the proper sequence to achieve... -
Consider facility-specific factors when drafting a query policy and procedure
Despite the fact that the American Health Information Management Association updated guidance for... -
Understand coding and billing challenges for pain management
When billing for pain management procedures, Stephanie Ellis, RN, CPC, explains that it is... -
Healthcare News: CMS alerts providers of scam to request account updates
On June 18, CMS released an alert through its fee-for-service provider listserv to warn physician... -
Q&A: Coding for multiple sessions of behavioral health treatment
QUESTION: I have a question regarding how to code for multiple sessions of behavioral health... -
Product of the week
Product of the week -
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Trivia question -
Coder chat
Coder chat -
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Issue 2, June 24, 2009
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New on JustCoding Platinum!
New on JustCoding Platinum! -
Survey Says: Use CDI Best Practices to Query Physicians
Most clinical documentation improvement professionals want to know how other facilities fare in... -
Pave the way for E/M documentation improvement: Coders should play a role in the process
Coders must be cognizant of medical necessity as it relates to record review and evaluation and... -
Eight essential questions every HIM director should ask about RAC record requests
How many record requests can HIM directors expect to receive now that the permanent Recovery Audit... -
Ensure medical necessity to curb outpatient revenue loss
Albert Einstein once said ‘Insanity is doing the same thing over and over again and expecting... -
Healthcare News: CMS posts new ICD-10 fact sheet and information about HIPAA Version 5010
On June 3, CMS posted the second in its series of articles about the ICD-10 general equivalency... -
Q&A: Coding unilateral versus bilateral mammograms
QUESTION: When a physician orders a unilateral screening mammogram on one breast and a unilateral... -
Product of the week
Product of the week -
Trivia winner
Trivia winner -
Coder chat
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Mini-poll -
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Quizlet
Quizlet
Issue 2, June 17, 2009
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New on JustCoding Platinum!
New on JustCoding Platinum! -
Documenting time is essential for coding critical care services
It’s all about timing when it comes to critical care codes, and coders need to make sure they... -
2010 IPPS proposed rule brings historic payment lows, few coding changes
When CMS released its May 1 proposal, hospitals received a mixed bag of news: There are minimal... -
Congenital anomalies: Know how and where to find them in the medical record
Sometimes a physician documents a congenital anomaly in the history and physical, discharge... -
Healthcare News: CMS posts 2010 ICD-9 code update to take effect October 1
On June 10, CMS posted the new, revised, and invalid diagnosis and procedure codes on its Web site... -
Q&A: Ensure detailed documentation when reporting group therapy codes with time-based descriptions
QUESTION: I have a question regarding behavioral health treatment sessions. What is the best method... -
Product of the week
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Trivia question -
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Issue 2, June 10, 2009
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New on JustCoding Platinum!
New on JustCoding Platinum! -
Evaluation and Management Auditing: Ensure appropriate coding and reimbursement for your practice
In this new white paper, Joe Rivet, CPC, CCS-P, CEMC, CICA, Revenue Cycle Institute regulatory... -
Be mindful of coder fatigue and work environment to foster optimal performance
The responsibilities inherent with coding require coders to strive for perfection in all of their... -
ICU documentation is critical: Reflect patient severity to get credit where credit is due
The importance of documentation is a subject many physicians don’t learn in medical school... -
CMS explains general equivalency maps to help the industry transition from ICD-9 to ICD-10
Although transitioning from ICD-9 to ICD-10 may be daunting, CMS has created a tool that can help... -
Healthcare News: CMS provides clarification regarding observation services and condition code 44
CMS has replaced the terms ‘observation status’ with ‘observation services&rsquo... -
Q&A: Report separate codes for individual IV administration services
QUESTION: How should we code the following scenario for a patient in the emergency room? A... -
Product of the week
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Trivia winner -
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Coder chat -
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Issue 2, June 3, 2009
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ICD-10 Watch Table
ICD-10 Watch Table -
New on JustCoding Platinum!
New on JustCoding Platinum! -
Diabetes
Diabetes -
Leishmaniasis
Leishmaniasis -
Pancytopenia
Pancytopenia -
AAPC 'Coder of the Year' says networking and learning from others leads to success
'Complete shock' are the two words that Barbara Fontaine, CPC, says came to mind when she found out... -
Know CPT code series for special services
Many providers and coders are unaware that the CPT Manual includes a series of codes to address... -
A coder and a physician team up to offer guidance on chronic left ventricular heart failure
Selecting a code for a patient with heart failure used to be fairly straightforward; fewer codes... -
Healthcare News: CMS publishes the July Integrated Outpatient Code Editor
On May 15, CMS published the July Integrated Outpatient Code Editor that will take effect July 1... -
Q&A: Contact payers to ensure compliant revenue code assignment when reporting code J1815
QUESTION: We receive rejected claims when we bill HCPCS code J1815 (Injection, insulin, per 5... -
Product of the week
Product of the week -
Trivia question
Trivia question -
Coder chat
Coder chat -
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Mini-poll -
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Issue 2, May 27, 2009
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New on JustCoding Platinum!
New on JustCoding Platinum! -
Seven simple steps to effectively staff your coding department
The question of how many coders you need to efficiently and effectively run the department may not... -
Podiatry coding: What you need to know to ensure compliance
Nearly 65% of podiatry claim errors occurred because of incorrect coding, according to CMS&rsquo... -
Table 1
Table 1 -
Documentation details vital to accurate wound care code assignment
In the recovery audit contractor demonstration evaluation report released in June 2008, CMS listed... -
Healthcare News: CMS issues transmittal that addresses requirements and deadlines for 5010 code set implementation
On May 15, CMS issued Transmittal 495 in the One-Time Notification Manual, which includes... -
Q&A: Report CPT code 99058 only in cases of true emergencies
QUESTION: A mother schedules an appointment for her son and brings her daughter along as well... -
Product of the week
Product of the week -
Trivia winner
Trivia winner -
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Coder chat -
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Quote of the week -
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Mini-poll -
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Table 2
Table 2
Issue 2, May 20, 2009
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New on JustCoding Platinum!
New on JustCoding Platinum! -
Incident To in Provider-Based Departments
In this new white paper, Kimberly Anderwood Hoy, JD, CPC, director of Medicare and compliance at... -
Employ a business-savvy CDI specialist to tackle chemotherapy services
The most prevalent challenge associated with operating a chemotherapy department is the increasing... -
Become well-versed in V codes to ensure accurate skilled nursing facility claims
Although coders in skilled nursing facilities have long been able to include V codes on claims... -
Q&A tackles frequent injection and infusion dilemmas
Providers can perform injections and infusions in a variety of different scenarios and under a... -
Healthcare News: CMS issues instructions for recoupment of overpayments related to MS-DRG 956
On May 8, CMS issued Transmittal 492 in the One-Time Notification Manual that addresses the mass... -
Q&A: Report separate E/M services when the physician provides supporting documentation
QUESTION: It is our understanding that when we schedule a new patient for his or her first wound... -
Product of the week
Product of the week -
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Trivia question -
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Coder chat -
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Mini-poll -
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Issue 2, May 13, 2009
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New on JustCoding Platinum!
New on JustCoding Platinum! -
Injections and infusions handout
Ensuring accurate capture of injection and infusion administration and drug codes is an important... -
Q&A addresses common injection and infusion conundrums
When someone says ‘injections and infusions,’ most coders launch into a flurry of... -
ASC coders beware: Is that screening colonoscopy really a screening?
The definition of a screening procedure may differ depending on who you ask. For example, a coder... -
Table 1
Table 1 -
Table 2
Table 2 -
The quick list: Eight sepsis coding tips
Sepsis. Septicemia. Bacteremia. Systemic Inflammatory Response Syndrome. Even the most experienced... -
Healthcare News: AMA updates corrections for 2009 CPT Manual
On May 5, the American Medical Association (AMA) updated corrections for the 2009 CPT Manual. For... -
Q&A: Codes for multiple dental extractions performed in a hospital outpatient department
QUESTION: When a Medicare patient presents to the hospital outpatient surgery department, and a... -
Product of the week
Product of the week -
Trivia winner
Trivia winner -
Coder chat
Coder chat -
Quote of the week
Quote of the week -
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Mini-poll -
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Quizlet
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Issue 2, May 6, 2009
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New on JustCoding Platinum!
New on JustCoding Platinum! -
Sample query form for chest pain
Use this sample query form for chest pain when you need more specific documentation from... -
Coding an IV infusion when the provider doesn't document a stop time
Providers frequently forget to document the stop time of an infusion, making it difficult for... -
Payment differences between inpatient consultations and subsequent visits
Payment differences between inpatient consultations and subsequent visits -
Key component requirements for consultations
Key component requirements for consultations -
Understand differences between consultations and referrals to ensure compliant coding
Consultation coding audits sometimes reveal that these types of visits should have been coded as... -
A coder’s perspective on avoiding seven potential coding traps
To ensure hospital compliance, the government and accrediting bodies constantly scrutinize... -
Healthcare News: CMS releases FY 2010 Inpatient Prospective Payment System proposed rule
CMS announced on May 1 a proposed rule and updated payment rates for inpatient services furnished... -
Q&A: How to report return visits for intravenous antibiotics
QUESTION: We have patients who return for intravenous antibiotics every 48 to 72 hours per... -
Product of the week
Product of the week -
Trivia question
Trivia question -
Coder chat
Coder chat -
Quote of the week
Quote of the week -
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Mini-poll -
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Last week’s mini-poll -
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Quizlet -
Correction
Correction
Issue 2, April 29, 2009
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New on JustCoding Platinum!
New on JustCoding Platinum! -
Injection and Infusion Coding and Billing
In this new white paper, Joe Rivet, CPC, CCS-P, CEMC, CICA, regulatory specialist at HCPro, Inc... -
Details matter when it comes to interventional radiology coding
Interventional radiologists diagnose and treat a wide range of diseases using targeted... -
Don’t mind these "don’t" directives
In a home healthcare world cluttered with scrutiny, providers are always looking for ways to... -
Tips for teaching consultation coding to physicians
Consultation coding can be challenging for many physicians, and correct documentation is vital to... -
Healthcare News: CMS updates RAC outreach schedule, FAQs
CMS has updated its recovery audit contractor (RAC) education and outreach schedule. The schedule... -
Q&A: Reporting contrast with lumbar CT
QUESTION: When a physician performs a lumbar myelogram (CPT code 72265) and a lumbar computed... -
Product of the week
Product of the week -
Trivia winner
Trivia winner -
Coder chat
Coder chat -
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Quote of the week -
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Mini-poll -
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Last week's mini-poll -
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Issue 2, April 22, 2009
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New on JustCoding Platinum!
New on JustCoding Platinum! -
Alert coders about new guidance for coding body mass index and pressure ulcers
Hospitals around the country face a new challenge: teaching coders that they can, in certain... -
Understand how to code for electroencephalograms
Healthcare providers use electroencephalograms (EEG) to measure and record the electrical activity... -
Bundle Branch Blocks
Bundle Branch Blocks -
Endometriosis
Endometriosis -
Urticaria
Urticaria -
Countdown to ICD-10: Devise a four-year training plan
Sue Bowman, RHIA, CCS, and Kathleen Wall, MS, RHIA, emphasize that HIM directors need to devise a... -
Healthcare News: CMS posts final decision memo for positron emission tomography for solid tumors
On April 3, CMS posted a final decision memo in which it announced revisions to Section 220.6 of... -
Q&A: Coding for screening colonoscopies
QUESTION: In MedLearn Matters article SE0746, CMS states that the primary diagnosis code for a... -
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Product of the week -
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Trivia question -
Coder chat
Coder chat -
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Word of the week -
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Mini-poll -
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Issue 2, April 15, 2009
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New on JustCoding Platinum!
New on JustCoding Platinum! -
2009 Medical Records Documentation Guide, Fourth Edition
HIM professionals and hospital accreditation coordinators can use this tool to identify areas in... -
Sepsis Q&As address common documentation challenges and how to assign the principal diagnosis
To further intensify the already challenging topic of coding for sepsis, physician documentation... -
AHIMA practice brief provides general ROI guidance
When it comes to release of information (ROI), there is no one-stop shop that provides HIM... -
Consider these seven sample case studies to help reduce misuse of modifier -25
Coders continue to struggle with the correct use of modifier -25 (significant, separately... -
Healthcare News: TrailBlazer yields nearly $1.1 million in outpatient overpayments, according to OIG report
On March 13, the Office of Inspector General (OIG) issued a report outlining several outpatient... -
Q&A: Reporting the administration of patient-controlled analgesia morphine
QUESTION: A patient presents to the emergency room (ER) on February 11 with pain related to... -
Product of the week
Product of the week -
Trivia winner
Trivia winner -
Coder chat
Coder chat -
Word of the week
Word of the week -
Quote of the week
Quote of the week -
Mini-poll
Mini-poll -
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Quizlet
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Issue 2, April 8, 2009
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Sample query form for heart failure
Use this sample query form for heart failure when you need more specific documentation from... -
Get on board with the 2009 OIG Work Plan
Understanding the areas of billing and compliance highlighted by the Office of Inspector General... -
Dedicated CDI specialist could help address chemotherapy coding and documentation challenges
Given the extremely high cost of chemotherapy services, it is likely that third-party payers... -
New on JustCoding Platinum!
New on JustCoding Platinum! -
Healthcare News: OIG reviews erroneous oxaliplatin billing at Texas hospital
On March 11, the Office of Inspector General (OIG) issued a final report regarding erroneous... -
Q&A: Billing for contrast material with CTs and MRIs
QUESTION: When a patient undergoes a computed tomography (CT) or magnetic resonance imaging (MRI... -
Product of the week
Product of the week -
Address these common Q&As related to SIRS documentation
With some of the most complicated documentation and coding guidelines, sepsis coding provides... -
Trivia question
Trivia question -
Coder chat
Coder chat -
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Word of the week -
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Mini-poll -
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Quizlet -
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Issue 2, April 1, 2009
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New on JustCoding Platinum!
New on JustCoding Platinum! -
Document E/M services to ensure appropriate code level assignment
Coding for evaluation and management services is no walk in the park for coders. They must rely on... -
Avoid these common mistakes when coding orthopedic procedures
This article provides a rundown of helpful coding tips for common orthopedic procedures. You can... -
RAC findings reflect need for coders to focus on SNF Part B billing for therapy services
The incorrect calculation of therapy units has led to many Part B billing errors for skilled... -
Healthcare News: CMS announces schedule for RAC outreach sessions
CMS announced on March 19 its schedule for recovery audit contractor outreach sessions. This... -
Q&A: Let dates of service dictate CPT code assignment
QUESTION: Each year, some CPT codes expire as of December 31, and new ones take effect January 1... -
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Issue 2, March 25, 2009
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New on JustCoding Platinum!
New on JustCoding Platinum! -
Sample query form for malnutrition
Use this sample query form for malnutrition when you need more specific documentation from... -
Review these important do's and don'ts when submitting mental health claims
Review these important do’s and don’ts when submitting mental health claims -
Coverage for mental health services depends on provider type
Mental health coding presents some unique challenges because coverage differs depending on the type... -
CPT add-on codes now cover most prolonged services
The deletion of modifier -21, effective January 1, isn’t likely to cause much distress. Joe... -
Coding for maintenance after gastric restrictive procedures differs by payer
Coding for laparoscopic band surgery is fairly straightforward, but selecting the appropriate... -
Healthcare News: CMS identifies 20 quality data codes that it mistakenly returned as unprocessed
CMS identified a technical problem affecting 20 quality data codes (QDC) used for reporting 13... -
Q&A: Documentation guidelines for coding consultations
QUESTION: Guidelines from the CPT Manual regarding consultation documentation state: The... -
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Issue 2, March 18, 2009
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CMS opens the door to outpatient HAC program: Expansion still under study
At a December 18, 2008 listening session, CMS presenters discussed possibilities for extending the... -
Avoid a cookie-cutter approach to CDI: Design a program that's right for you
Implementing a successful clinical documentation improvement (CDI) program will not only improve... -
Anesthesia coding calls for extra education
To understand how to correctly assign codes for anesthesia services, coders must possess more than... -
Healthcare News: CMS announces new policy to cover certain sleep tests to diagnose obstructive sleep apnea
CMS announced March 3 that it will provide coverage for specified sleep tests that physicians use... -
Q&A: How to report anticoagulant management when multiple providers render services
QUESTION: Providers should report anticoagulant management codes 99363 and 99364 when a physician... -
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Issue 2, March 11, 2009
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Master physician queries: Clarify coding with compliant questions
This new white paper provides an overview of the American Health Information Management Association... -
Coding for precipitous labor and deliveries presents murky dilemma
A precipitous labor or precipitous delivery is defined as a labor and delivery that results after... -
Now is the time to start planning your roadmap to ICD-10
The implementation road to ICD-10 may be a lengthy one, but just as with any long road trip, when... -
Know how the EHR could reshape your department and job
It’s every HIM director’s dream: A relatively seamless electronic health record (EHR... -
Healthcare News: CMS advises payers to bolster review of claims with modifier -79
CMS urged fiscal intermediaries and carriers to strengthen their program safeguards by March 16 to... -
Q&A: Billing for tissue and skin graft procedure for the same episode of care
QUESTION: Can outpatient clinics bill for both the skin graft procedure and tissue used for that... -
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Issue 2, March 4, 2009
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Medical Records Forms Approval Process
Laura J. Rizzo, MHA, RHIA, director of health information management at Lancaster General in... -
Coding doesn't have to be a pain in the ear: Understand the criteria for reporting cerumen removal
Physicians and coders alike are often unsure of how to code cerumen or ear wax removal. Many feel... -
Out with the old, in with the new: Revise injection and infusion coding policies in light of 2009 changes
Jugna Shah, MPH, and Valerie Rinkle, MPA, discuss the payment rate changes for certain injection... -
Gain insight into three types of codes to clarify reporting for home health services
Diane Omdahl, RN, MS, takes a closer look at case-mix diagnosis codes, HCPCS codes, and revenue... -
Healthcare News: Four HCPCS codes now subject to CLIA edits, according to new CMS transmittal
Four HCPCS codes are now subject to Clinical Laboratory Improvement Amendments (CLIA) edits... -
Q&A: Documenting the history of present illness
QUESTION: It’s my understanding that according to the evaluation and management (E/M... -
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Issue 2, February 25, 2009
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New on JustCoding Platinum!
New on JustCoding Platinum! -
Macular degeneration
Macular degeneration -
Polycystic ovarian syndrome
Polycystic ovarian syndrome -
Seek specificity in heart failure documentation to better reflect patient severity, ensure accurate coding
If your facility has seen a huge decrease in cardiovascular (CV) reimbursement since the... -
EHR compliance: Audit the use of the copy function
As electronic health records (EHR) become more common, particularly in light of the new economic... -
Form a RAC response team before it's too late
The time, expertise, and energy required to build a recovery audit contractor (RAC) response... -
Healthcare News: CMS issues final coverage policy for bariatric surgery for non-morbidly obese patients
On February 12, CMS announced its final coverage policy for bariatric surgery as a treatment for... -
Q&A: Documentation for toxic metabolic encephalopathy
QUESTION: I need further clarification regarding documentation of toxic metabolic... -
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Creutzfeldt-Jakob disease
Creutzfeldt-Jakob disease
Issue 2, February 18, 2009
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New on JustCoding Platinum! -
The New ABN: Specifics to ensure your team is ready to use the new notice
This recently updated white paper provides an overview of the new Advance Beneficiary Notice of... -
Use condition code 44 with care to avoid becoming a RAC target
Condition code 44 is difficult to implement because CMS does not provide clear guidance regarding... -
Pricey dialysis requires auditing
Expensive, complicated procedures come with compliance challenges and intense scrutiny from... -
Accurately document hemorrhage severity: Get to know your bleeds to ensure proper coding
Robert S. Gold, MD, discusses hemorrhages and diagnoses in the emergency department and walks... -
Healthcare News: First phase of RAC expansion to begin in March
On February 10, CMS posted a new recovery audit contractor phase-in map to the CMS Web site. CMS... -
Q&A: Billing for lab services
QUESTION: We take specimens at the lab in our hospital and forward them to a different lab for... -
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Issue 2, February 11, 2009
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Breaking News from HCPro
View HCPro’s e-blast covering the breaking news that CMS announced on February 6 that the... -
New on JustCoding Platinum!
New on JustCoding Platinum! -
Connect the clinical dots to ensure compliant coding in the LTAC setting: Identify strategies to engage providers in the process
In many ways, the coding process at a long-term acute care (LTAC) facility mimics the childhood... -
Understand 2009 changes to hernia repair codes
The American Medical Association made some significant changes to the hernia repair codes in the... -
ICD-10 in 2013: Will you and your staff be ready?
The news is out: October 1, 2013, is the deadline by which HIM directors must diligently spearhead... -
Healthcare News: CMS announces three NCDs for surgical never events
On January 15, CMS announced three National Coverage Determinations (NCD) to establish uniform... -
Q&A: Radiology billing for multiple studies on the same day
QUESTION: A physician performs an ultrasound exam of the abdomen and pelvis on the same day for a... -
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Breaking News from HCPro
View HCPro’s e-blast covering the breaking news that CMS revised its recovery audit...
Issue 2, February 4, 2009
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New on JustCoding Platinum! -
Connect the clinical dots to ensure compliant coding in the LTAC setting: Ask these questions when coding complex cases
Patients in long-term acute care facilities typically present with a complicated and lengthy set of... -
Don't leave money on the table: Report eligible devices under OPPS
Effective January 1, coders can report HCPCS code C9899 when providers implant a prosthetic device... -
Understand the new V codes for antenatal screening
Effective October 1, 2008, coders began reporting new V codes for antenatal screening. These codes... -
Healthcare happenings: New CPT codes not available in NCCI edits until April 1
Coders beware: New drug administration CPT codes will not trigger National Correct Coding... -
Q&A: CPT code for the application of an Unna boot
QUESTION: When a nurse applies an Unna boot in the clinic setting, but a physician does not see the... -
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Issue 2, January 28, 2009
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New on JustCoding Platinum! -
Look for specific documentation when coding diabetes mellitus
Secondary diabetes—a new ICD-9-CM code category for 2009—refers to elevated blood sugar... -
Guidelines for reporting CRT-D pacemaker implantation: Be aware of Coding Clinic advice
Cardiac resynchronization therapy defibrillator (CRT-D) implantation is a technology that... -
MS-DRGs applicable to most CRT-D implantations
MS-DRGs applicable to most CRT-D implantations -
Capture PQRI data with an organized workflow
If you aren’t participating in CMS’ Physician Quality Reporting Initiative (PQRI... -
Healthcare happenings: AMA publishes corrections document for 2009 CPT codes
On December 16, the American Medical Association published its corrections document for the 2009... -
Q&A: Revenue codes for cardiopulmonary resuscitation
QUESTION: An ER patient undergoes cardiopulmonary resuscitation. Can we charge for this procedure... -
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Issue 2, January 21, 2009
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Recovery Audit Contractors Demonstration Program White Paper
This recently updated white paper addresses the Recovery Audit Contractor (RAC) demonstration... -
Understand the pitfalls of mapping medical decision-making from a diagnosis
Evaluation and management (E/M) coding is sometimes difficult even for the most experienced coders... -
Take the pain out of immunizations with roster billing
If your long-term care facility administers influenza or pneumonia vaccines to large groups of... -
CMS extends coverage for the initial preventive physical examination
CMS extensions of coverage are rare gifts, but according to Medlearn Matters article MM6223, which... -
Healthcare happenings: ICD-10 implementation set for 2013, according to HHS final rule
On January 15, the Department of Health and Human Services (HHS) released the long-awaited ICD-10... -
Q&A: Coding a diagnosis of full thickness burn of the colon wall following polpectomy
QUESTION: How do you code a diagnosis of full thickness burn of the colon wall with serosal... -
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Sample Template for Initial Preventive Physical Examination
Lori-Lynne Webb, CPC, CCS-P, CCP, an independent coding consultant in Melba, ID, shares this sample... -
Breaking news from HCPro
View HCPro’s e-blast covering the breaking news that the Department of Health and Human... -
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Issue 2, January 14, 2009
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Ensure that coders and physicians understand the intricacies of medical necessity
Medical necessity is a topic that permeates Medicare rules and other regulations governing delivery... -
Work with physicians to obtain clear-cut documentation for pressure ulcers
Applying the present on admission (POA) indicator to pressure ulcers is no easy task. Coders often... -
Use critical care codes correctly to ensure compliance
Ruth Dolby discusses CMS’ newly issued payment policy guidelines that will have a vital... -
Healthcare Happenings: More than 99% of participating hospitals to receive full payment update under outpatient quality data reporting program
On January 8, CMS announced the results of the first hospital outpatient quality data reporting... -
Q&A: Query to determine the relationship between aspiration pneumonia and drug overdose when documentation is insufficient
QUESTION: When a physician documents both aspiration pneumonia and drug overdose as present and... -
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Issue 2, January 7, 2009
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New on JustCoding Platinum!
New on JustCoding Platinum! -
Idiopathic thrombocytopenia purpura
Idiopathic thrombocytopenia purpura -
Impetigo
Impetigo -
Raynaud's phenomenon
Raynaud’s phenomenon -
Understand the role of condition codes in the SNF setting to prevent payment delays
CMS Transmittal 1565 shines the spotlight on an often-overlooked UB-04 coding element: the... -
Know that billing rules for device-intensive procedures can vary among payers
Last year, CMS significantly changed the way that it paid ambulatory surgery centers (ASC... -
Know the rules for billing inpatient-only procedures
The rule for inpatient-only procedures in an outpatient setting may initially seem rather basic... -
Healthcare happenings: CMS proposes three NCDs for surgical "never" events
On December 2, 2008, CMS proposed three National Coverage Determinations (NCD) to establish uniform... -
Q&A: Coding an infected lumbar wound
QUESTION: I report ICD-9-CM code 876.1 for an infected lumbar wound. However, the insurance company... -
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