Bones are typically resistant to bacterial colonization, but events such as trauma, surgery, the presence of foreign bodies, or the placement of prostheses may disrupt bony integrity, or a result of a spread after bacteremia, and lead to the onset of bone infection caused by an infectious organ... Read More
By: Codapedia Editor (Jun/01/2015)
I can count on two consistent issues in coding audits. Doctors report that their patients are, in general, sicker than patients in other practices. Coders report that their physicians are, in general, worse documenters than phy... Read More
Many healthcare organizations are not aware of how critically important it is to screen their employees against ALL state and federal exclusions databases. The OIG is reviewing organizations in ALL federal healthcare programs - this includes Medicare, Medicaid, CHIP, etc. - for those... Read More
The Patient Access and Medicare Protection Act (PAMPA) was recently signed into law on December 28, 2015. Beginning January 1, 2016, the DME fee schedule rates are adjusted to reflect information from the DMEPOS competitive bidding program as required by section 1834(a)(1)(F)(ii) of the Social... Read More
As you probably know, HIPAA stands for the Health Insurance Portability and Accountability Act.This means that as healthcare professionals, we must hold ourselves accountable when handling patient information. This goes beyond having conversations with unauthorized people about what we see or he... Read More
If you have worked in billing and reimbursement, you are aware that turning patients over to a collection agency to collect on a debt should always be a last resort. Are your office policies conducive to retaining happy, paying patients or harming the word-of-mouth advertising so i... Read More
There are numerous Medicare & Medicaid review programs which have been created to step the problems of improper payments, fraud and abuse within these federal programs. CMS is currently working with Integrity Management Services to consolidate and simplify. The resulting Unified Program Integrit... Read More
New Find-A-Code feature! MSP:Medicare Secondary Payer (MSP) is the term generally used when the Medicare program does not have primary payment responsibility - that is, when another entity has the responsibility for paying before Medicare. When Medicare began in 1966, it was the primary payer for al... Read More
In short, MIPS is the new Medicare payment incentive/penalty system which will begin in 2019. The Medicare Access and CHIP Reauthorization Act of 2015 (also known as the SGR repeal or 'doc fix') included the creation of a new pay-for-performance program called the Merit-Based Incentiv... Read More
When reading through documentation in an operative report for a hysterectomy, for the ‘Procedure Performed’, a ‘TAH-BSO, and Omenectomy’ is performed. As with all operative reports, there are guidelines that should be followed when determining the appropriate ICD-10-PCS codes... Read More
For inpatient coding, there are times when the diagnosis(es) cannot be established at the time of admit or throughout the course of the admission. In these cases, they are documented in the medical record as “probable,” “suspected,” “likely,” “questionable,&... Read More
Be sure to use the code set that is effective and valid for the date of service the patient was seen or your claim will be denied.You cannot submit ICD-9-CM codes on a claim for any encounter after October 1, 2015.
A claim cannot contain both ICD-9-CM and ICD-10-CM codes, it will be returned... Read More
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