While all medical specialties run the risk of being audited, podiatry ranks especially high for audit risk. That puts you on your toes (pun intended!) when submitting claims. Payers want to see your confidence on even the trickiest aspects of coding, which for 2019 includes More..
Scenario: A patient comes into an orthopedic office for an injury that has persisted for 5 months. Should your claim include an ICD-10 code for an acute or a chronic injury? On the one hand, the problem has been going on for only 5 months; More..
A quick Google search for the term “medical necessity” doesn’t turn up anything you don’t already know. In fact, most sites give some version of this definition: “health care services that a physician, exercising prudent clinical judgment, would provide to a patient.” The definition’s vagueness More..
Studies have been showing for a while a glaring problem in the U.S. – inadequate care for patients who show up at emergency departments (EDs) with behavioral health challenges. In the defense of ED staff, these challenges are difficult to assess. Add to that the More..
When your entire way of doing something changes, adjusting takes time – especially when that “something” is 41 pages of detailed changes to the already unwieldy hospital Conditions of Participation (CoPs). These extra changes to radiology and nuclear medicine have many hospitals confused, particularly when More..
It’s no secret that more and more practices are using skilled non-physician practitioners (NPPs) to provide efficient and patient-centered care – and why shouldn’t they? A 2014 Medical Group Management Association (MGMA) analysis reports that 68 percent of highly functioning practices employed NPPs. And with More..
Think fast: how quickly can you name the different components of hysterectomy, hysteroscopy, and laparoscopy services? Chances are coding for these and other gynecological services can trip you up, as they often do even the most seasoned coder. Unless you’re well-versed in best-practice coding, you More..
What’s the price tag of inadequate discharge planning? For fiscal year (FY) 2018, it’s right around $564 million, according to analysts at the Advisory Board. And that’s just the penalty inflicted for preventable readmissions. Hospitals also have to worry about the costs involved in treating More..
“It’s not the years in your life that count, but the life in your years,” goes the saying, one that could very well be the motto for the Centers for Medicare & Medicaid Services (CMS) in their new survey process instituted last November. Using “f-tags” More..
Incorrectly coding a patient’s hospital status could cost your physicians significantly, even years down the road. The Centers for Medicare & Medicaid Services (CMS) has been aggressively reviewing inpatient and observation claims to reduce the amount of improper payments. When you’re under such scrutiny, thorough More..