Life Care Planners

News and Important Information

Coding with PCS When There is No Code 

VA-UCR Prof Services Modifier Charge Factor

Newest Launch - We Now Have Outpatient Facility Pricing!

Tools and Resources for Life Care Planners

Spinal Cord Stimulator Used for Chronic Pain


CLICK HERE to view Find-A-Code's website demo for Nurse Life Care Planners

 

Resources

Find-A-Code's Tools & Resources

Select the title to see a summary and a link to the full article.  some articles require a subscription to view.

CMS Unveils 2024 Medicare PFS, OPPS Proposed Rules

by  Mark Spivey

The OPPS proposal did not feature reference to several high-profile issues industry leaders have been awaiting reform on. Federal officials yesterday unveiled a pair of proposed rules, featuring potential adjustments to the Medicare Physician Fee Schedule (PFS) and Outpatient Prospective Payment System (OPPS) for the 2024 calendar year....

Understanding, Identifying, and Reporting Combination Codes

by  Aimee L. Wilcox, CPMA, CCS-P, CST, MA, MT

Coders often see conditions that seem to always be reported together. Diabetic patients tend to develop other conditions as the diabetes continues to progress instead of improving. Combination codes are one of those types of codes that identify multiple conditions or diseases but have their own set of special coding guidelines.

What’s Going on with the COVID Vaccines Now?

by  Wyn Staheli, Director of Content - innoviHealth

Keeping up with the changes to the COVID vaccines has certainly been a rollercoaster ride and we now have two new twists to this exciting ride. Buckle up and let’s look at how this changes things.

Second Quarter 2023 Updates are Different This Year

by  Wyn Staheli, Director of Content - innoviHealth

The second quarter of 2023 is NOT business as usual so it is important to pay attention to ensure that organizational processes and training take place to avoid mistakes. Not only have ICD-10-CM coding updates been added to the usual code set updates (e.g., CPT, HCPCS, ICD-10-PCS), but the end of the COVID-19 Public Health Emergency will bring about changes that will also take place during the quarter (but not on April 1, 2023.

HCC Re-Structuring Coming Soon!

by  Christine Woolstenhulme, QMC QCC CMCS CPC CMRS

What is the ICD-10 Code For Dementia?

by  Wyn Staheli, Director of Content - innoviHealth

Dementia is a neurocognitive disorder characterized by a meaningful decline in cognition and daily functioning. As of October 1, 2022, there were some significant changes in regards to reporting this condition, so it is important for healthcare professionals to be aware of those changes to ensure that there is proper documentation supporting the ICD-10-CM diagnosis code reported

CMS Announces Changes to DME Program

by  Wyn Staheli, Director of Content - innoviHealth

CMS recently announced that there have been some changes made to the DMEPOS program. The Medicare Learning Network (MLN) “DMEPOS Quality Standards” lists several changes to the program. Read more about understanding these changes.

New Modifier Required on all Single-Use Drugs- JZ and JW Modifiers

by  Christine Woolstenhulme, QMC QCC CMCS CPC CMRS

Attention providers and suppliers, there is a new modifier in town! Starting July 1, 2023, Modifier JZ - Zero Drug wasted will be required on all claims to attest there is no drug leftover, If applicable.

Is the End Really Near?

by  Christine Woolstenhulme, QMC QCC CMCS CPC CMRS

What happens once the COVID-19 emergency declarations have ended?

Relative Value Units (RVUs) the Easy Way, Really?

by  Christine Woolstenhulme, QMC QCC CMCS CPC CMRS

The Medicare Physician fee schedule was implemented in 1992 using a relative Value scale methodology called RVUs to base payment rates on the resources used to perform the service. This is currently how the Medicare Physician Fee Schedule (MPFS) is set. But beware, there may be an industry-wide change to a Value-Based Payment. We will save that for another time; this article will focus on how the RVUs are calculated and Medicare Fee schedules.

E/M Transformations and Clarifications Eff January, 1 2023

by  Christine Woolstenhulme, QMC QCC CMCS CPC CMRS

Pay close attention to the new code description changes when coding E/M in 2023, the changes keep coming. Several codes have been consolidated, revised, or deleted. Learn what to look for in this article.

Accurately Reporting Diabetic Medication Use in 2023

by  Aimee L. Wilcox, CPMA, CCS-P, CST, MA, MT

Along with the ICD-10-CM coding updates, effective as of October 1st, the guidelines were also updated to provide additional information on reporting diabetic medications in both the general diabetic population and pregnant diabetics. Accurate reporting is vital to ensure not only maximum funding for risk adjusted health plans, but also to ensure medical necessity for the services provided to this patient population.

REMINDER: CMS Discontinuing the use of CMNs and DIFs- Eff Jan 2023 Claims will be DENIED!

by  Christine Woolstenhulme, QMC QCC CMCS CPC CMRS

Updated Article - REMINDER! This is important news for durable medical suppliers! Effective January 1, 2023, CMS is discontinuing the use of Certificates of Medical Necessity (CMNs) and DME information forms (DIFs). We knew this was coming as the MLN sent out an article on May 23, 2022, but it is time to make sure your staff knows about these changes.

2022-11-23-MLNC - Weekly Edition

Colorectal Cancer Screening Test: Reduced Coinsurance for Related Procedures Begins January 1 - - Ambulance Fee Schedule: CY 2023 Inflation Factor & Productivity Adjustment - - Medicare Ground Ambulance Data Collection System: Information to Help You Report - -...

How Does the Definition of "Problem Assessed" Change in the 2023 E/M Guideline Updates?

by  Aimee L. Wilcox, CPMA, CCS-P, CST, MA, MT

The 2023 Evaluation and Management changes have been published and efforts are ongoing to educate coders and provider organizations on the guideline and code description changes that will impact professional coding in the facility setting. These changes required a significant revision to the guidelines and definitions of the various levels of complexity associated with the Number and Complexity of "Problems Addressed" during an encounter, which is the first element of medical decision making (MDM) and the following explanations and examples should provide a greater understanding of the changes headed our way in January.

Four Ways Your Organization Can Benefit from Gathering and Reporting Social Determinants of Health Data

by  Aimee L. Wilcox, CPMA, CCS-P, CST, MA, MT

Providers who actively engage in collecting and reporting social determinants of health (SDoH) open avenues of identifying and treating their patients' population health trends. Pairing chronic conditions that are difficult to control with identified SDoH circumstances such as transportation or electricity insecurity, can help identify those patients who may wish to be healthier, but who are dealing with circumstances that prevent compliance, such as transportation or access to electricity, for instance.

2023 Evaluation & Management Updates Free Webinar

by  Aimee L. Wilcox, CPMA, CCS-P, CST, MA, MT

Congratulations on a successful 2021 implementation of the Evaluation and Management (E/M) changes! That was a big change, but now an even bigger change is headed your way for inpatient and all other E/M categories. How great is it that almost all of the E/M categories will now be scored based on medical decision making (MDM) or total provider time? Standardized scoring and one set of E/M guidelines has the potential of bringing about a change or improvement of provider fatigue due to over regulation and documentation burden.

End-Stage Renal Disease Risk Model Updates for 2023

by  Aimee L. Wilcox, CPMA, CCS-P, CST, MA, MT

For the first time, ESRD Medicare beneficiaries were permitted to enroll in Medicare Advantage plans beginning in 2021. Since that time, CMS has been working to revise the program to reduce costs, improve quality, and drive benefits. Effective January 1, 2025, one such change will include a definition change for "oral-only drugs." Why is Medicare changing the definition of these drugs and how will that be a driving force in advancing care models for ESRD in the future?

Seven Major Changes Proposed by CMS in the 2023 Proposed Rule

by  Aimee L. Wilcox, CPMA, CCS-P, CST, MA, MT

As the COVID-19-related public health emergency (PHE) seems to be dying down, CMS publishes the 2023 Medicare Proposed Rule that outlines more than a dozen major changes to existing programs, including some that relate to telemedicine after the PHE is declared officially over. Of the many changes, seven (7) really stand out and make us think about how the end of the PHE may affect services such as telemedicine or new E/M encounter types.

Significant Changes to Emergency Department E/M Reporting Coming in 2023

by  Aimee L. Wilcox, CPMA, CCS-P, CST, MA, MT

In just a few short months, major revisions to the remaining Evaluation and Management categories in the Current Procedural Terminology (CPT) code book will go into effect. How many of these changes will affect your organization and how ready are you for them? While the changes to the remaining E/M categories will closely resemble the 2021 changes to the E/M Office and Other Outpatient (99202-99215) codes, there are some major differences that need to be carefully reviewed, such as how E/M will change for the Emergency Department services.

There are 246 related documentation, coding and billing tips.

Subscribers will see related documentation, coding and billing tips. Access to this feature is available in the following products:
  • Find-A-Code Professional
  • Find-A-Code Premium
  • Find-A-Code Elite
  • Find-A-Code Facility Base
  • Find-A-Code Facility Plus
  • Find-A-Code Facility Complete
  • HCC Standard
  • HCC Pro

Select the title to see a summary and a link to the full webinar information.  some webinars require a subscription to view.

Keeping up to date on reporting changes... 

by  Aimee L. Wilcox, CPMA, CCS-P, CST, MA, MT

Properly reporting split or shared patient encounters can be tricky. The CPT codebook just began defining this type of encounter and the 2023 Medicare Physician Fee Schedule Final Rule included some changes. Tune into this informative webinar to ensure that you are doing things the right way.

Coding 2022 Care Management Services 

by  Aimee L. Wilcox, CPMA, CCS-P, CST, MA, MT

Rock Solid Care Plans 

by  Evan M. Gwilliam, DC MBA CPC CCPC CPC-I QCC MCS-P CPMA CMHP AAPC Fellow

Don't ever let anyone challenge your care plans ever again. If you can know what the regulators are looking for while still being free to deliver the care you deem to be best for your patient, then you win. And your patient wins. Join Dr. Gwilliam, certified professional medical auditor, and all around nice guy, as he guides you to the steps to create rock solid care plans that will stand up to third party scrutiny.

ICD-10-CM Changes Effective October 1, 2019 

by  Aimee L. Wilcox, CPMA, CCS-P, CST, MA, MT

Are you aware of the ICD-10-CM code changes set take effect as of October 1, 2020? Do any of them apply to your organization? Which of them will be assigned as an HCC? What are the documentation and coding guidelines applicable to them and which guidelines are changing or being ...

Telehealth Policies for Medicare and Commercial Payers 

Telehealth Policies for Medicare and Commercial Payers

E/M and the Organ Systems Part 2 of 2 

E/M and the Organ Systems Part 2 of 2

E-M and the Organ Systems (Part 1) 

E-M and the Organ Systems (Part 1)

HCC Coding Tool 

by  Find-A-Code™

How to use Find-A-Code's HCC Coding Tool

Anatomy of the Ankle and Common Injuries 

by  Find-A-Code™

Join Brandon Leavitt as we master the anatomy of the foot and ankle and common diseases and injuries which are found with this joint. We will also cover how these terms are described in ICD-10-CM.

Success with Out-of-Network Billing in Today's Environment Part 2 

by  Find-A-Code™

In this webinar Maxine will be presenting information and tips for understanding and billing Employment Retirement Income Security Act (ERISA) insurance plans. She will explain the rules and regulations concerning ERISA plans, as well as procedures for handling/appealing "adverse denials" of claims. Coders and Insurance Billing Specialists should not miss this informative presentation.

Success with Out-of-Network Billing in Today's Environment Part 1 

by  Find-A-Code™

In this webinar Maxine will be presenting information and tips for understanding and billing Employment Retirement Income Security Act (ERISA) insurance plans. She will explain the rules and regulations concerning ERISA plans, as well as procedures for handling/appealing "adverse denials" of claims. Coders and Insurance Billing Specialists should not miss this informative presentation.

Anatomy and Diagnostic Coding for Wound Care 

by  Find-A-Code™

In this webinar, Brandon Leavitt will review the anatomy of wounds from injury, disease, and other conditions and the proper ICD-10-CM coding for them. A review of pressure and non-pressure, and venous stasis ulcers, burns, corrosions, neoplasms, and other diseases affecting the integument will be presented.

Coding and Auditing Wound Care 

by  Find-A-Code™

In this webinar, Aimee will review wound care coding and auditing information for wound care services, including proper modifier use, NCCI edits, Medicare coverage guidelines, and documentation requirements.

All About Knee Coding & Auditing 

by  Find-A-Code™

Total knee replacement now acceptable ASC procedure also, not auditing for a year. Knee replacement coding, knee joint injections, auditing using FAC, LCDs, drugs, modifiers.

Evaluation and Management Coding and Auditing 

by  Find-A-Code™

Are you responsible for selecting or reviewing Evaluation and Management service levels? Do you wonder how well you know the rules and how to apply them? Join Aimee in this webinar to review and then applly the rules of E/M coding. She will also do a live demonstration of the new Find-A-Code E/M Calculator Tool to assess the level of E/M service for two office visits, one new (99201-99205) and the other established (99212-99215).

Coding and Auditing TeleHealth Services 

by  Find-A-Code™

Do you report or audit Telemedicine services now or are you considering offering them? Come and learn more about the rules and guidelines surrounding Telehealth services including, documentation requirements, eligible CPT and HCPCS Level II codes, modifiers, and the newest updates to Medicare Telehealth policies.

Using Find-A-Codes Anatomy Images 

by  Find-A-Code™

Diagnosis coding is difficult when clinician documentation does not match up with the definitions found in the ICD-10-CM code set. Find-A-Code's anatomy images educate both coders and students - bridging the gap between coders and clinicians while simplifying code selection.

FAC Updates Plus Tools for HCC Coding Chart Review February 

by  Find-A-Code™

Join Taylor to see how you can access free CEUs in 3 clicks, included with top-tier Find-A-Code subscriptions! Also highlighting our New and Improved NCDs system, and how to use the WK Drug Database for HCC Coding/Chart Review

2018 Updates and New Tools 

by  Find-A-Code™

2018 Find-A-Code updates and new tools

Proper Coding and Billing for Drugs, Biologicals and Injections 

by  Find-A-Code™

Proper Coding and Billing for Drugs, Biologicals and Injections

The Importance of Gathering Organizing and Using Fee Schedules 

by  Find-A-Code™

The Importance of Gathering Organizing and Using Fee Schedules

Using Find-A-Code's New Evaluation and Management Calculator Tool 

by  Find-A-Code™

Using Find-A-Code's New Evaluation and Management Calculator Tool

HCC Risk Adjustment 

by  Find-A-Code™

HCC Risk Adjustment

Does a Self-Care Rx Effect Medical Reimbursement and How? 

by  Tom Grant DC, Med-Legal Consultant, Pragma Intel Director of Education

This is the easiest of therapies to initiate and it adds great medical value. Most DC's do not prescribe/proscribe self-care instructions. Self-care Rx's have defined timelines for implementation and updates. Done incorrectly, self-care Rx's damage medical value and decrease reimbursements.

How to Check NCCI Edits Using FindACode 

by  Find-A-Code™

How to Check NCCI Edits Using FindACode

ICD-10-CM Updates for the Auditor, a NAMAS webinar 

by  Find-A-Code™

ICD-10-CM Updates for the Auditor, a NAMAS webinar

ICD-10-CM Training - Session 01 

by  Find-A-Code™

ICD-10-CM Training - Session 01

ICD-10-CM Training - Session 02 

by  Find-A-Code™

ICD-10-CM Training - Session 02

ICD-10-CM Training - Session 03 

by  Find-A-Code™

ICD-10-CM Training - Session 03

ICD-10-CM Training - Session 04 

by  Find-A-Code™

ICD-10-CM Training - Session 04

ICD-10-CM Training - Session 05 

by  Find-A-Code™

ICD-10-CM Training - Session 05

ICD-10-CM Training - Session 06 

by  Find-A-Code™

ICD-10-CM Training - Session 06

ICD-10-CM Training - Session 07 

by  Find-A-Code™

ICD-10-CM Training - Session 07

ICD-10-CM Training - Session 08 

by  Find-A-Code™

ICD-10-CM Training - Session 08

ICD-10-CM Training - Session 09 

by  Find-A-Code™

ICD-10-CM Training - Session 09

ICD-10-CM Training - Session 10 

by  Find-A-Code™

ICD-10-CM Training - Session 10

ICD-10-CM Training - Session 11 

by  Find-A-Code™

ICD-10-CM Training - Session 11

ICD-10-CM Training - Session 12 

by  Find-A-Code™

ICD-10-CM Training - Session 12

ICD-10-CM Training - Session 13 

by  Find-A-Code™

ICD-10-CM Training - Session 13

ICD-10-CM Training - Session 14 

by  Find-A-Code™

ICD-10-CM Training - Session 14

ICD-10-CM Training - Session 15 

by  Find-A-Code™

ICD-10-CM Training - Session 15

ICD-10-CM Training - Session 16 

by  Find-A-Code™

ICD-10-CM Training - Session 16

ICD-10-CM Training - Session 17 

by  Find-A-Code™

ICD-10-CM Training - Session 17

ICD-10-CM Training - Session 18 

by  Find-A-Code™

ICD-10-CM Training - Session 18

ICD-10-CM Training - Session 19 

by  Find-A-Code™

ICD-10-CM Training - Session 19

ICD-10-CM Training - Session 20 

by  Find-A-Code™

ICD-10-CM Training - Session 20

ICD-10-CM Training - Session 21 

by  Find-A-Code™

ICD-10-CM Training - Session 21

ICD-10-CM Training - Session 22 

by  Find-A-Code™

ICD-10-CM Training - Session 22

ICD-10-CM Training - Session 23 

by  Find-A-Code™

ICD-10-CM Training - Session 23

ICD-10-CM Training - Session 24 

by  Find-A-Code™

ICD-10-CM Training - Session 24

ICD-10-CM Training - Session 25 

by  Find-A-Code™

ICD-10-CM Training - Session 25

ICD-10-CM Training - Session 26 

by  Find-A-Code™

ICD-10-CM Training - Session 26

ICD-10-CM Training - Session 27 

by  Find-A-Code™

ICD-10-CM Training - Session 27

ICD-10-CM Training - Session 28 

by  Find-A-Code™

ICD-10-CM Training - Session 28

ICD-10-CM Training - Session 29 

by  Find-A-Code™

ICD-10-CM Training - Session 29

ICD-10-CM Training - Session 30 

by  Find-A-Code™

ICD-10-CM Training - Session 30

ICD-10-CM Training - Session 31 

by  Find-A-Code™

ICD-10-CM Training - Session 31

ICD-10-CM Training - Session 32 

by  Find-A-Code™

ICD-10-CM Training - Session 32

ICD-10-CM Training - Session 33 

by  Find-A-Code™

ICD-10-CM Training - Session 33

ICD-10-CM Training - Session 34 

by  Find-A-Code™

ICD-10-CM Training - Session 34

ICD-10-CM Training - Session 35 

by  Find-A-Code™

ICD-10-CM Training - Session 35

ICD-10-CM Training - Session 36 

by  Find-A-Code™

ICD-10-CM Training - Session 36

Links and resources by topic.

Medicare
NDC - National Drug codes

Compliance  (2022-06-16)

Implanted Spinal Neurostimulators: Document Medical Records

In a recent report, the Office of Inspector General found that Medicare improperly paid claims for implanted spinal neurostimulators when providers didn’t provide sufficient documentation supporting medical necessity. For dates of service on or after July 1, 2021, you must ask your Medicare Administrative Contractor to authorize these services before performing the procedure in the hospital outpatient department.

Learn what you need to include in patient medical records:

suggest a resource

If you know of a resource that should be included here (links, data, etc.) please contact us.

demo
request yours today
subscribe
start today
newsletter
free subscription

Thank you for choosing Find-A-Code, please Sign In to remove ads.