Two recent cases, one settled and one just filed, are illustrative of the effects of class actions, which are filed in relation to an underlying data breach involving PHI.
Tricky coding diagnoses
Sometimes, the difficulty in treating patients lies in knowing how to code their ailments.
‘Patients over Paperwork’ or bait and switch?
Coding expert Bill Dacey reacts to CMS’s 2019 proposed Medicare Physician Fee Schedule that would collapse office Evaluation and Management code levels-and payment rates.
A round up on DOJ actions against coding abuse
A look at recent lawsuits the U.S. Department of Justice has pursued for illegal upcoding, downcoding, and excessive coding claims.
Thoughts on CMS’s dramatic proposal for E/M guidelines
Here are five reasons why CMS’s proposed Physician Fee Schedule for Evaluation and Management guidelines might improve patient care.
ICD-10: The page-turning best seller
The lesser known follow-up to Dan Brown's international best seller, "The Da Vinci Code," is ICD-10, featuring less clues but plenty of confusing codes. Get your hands on a copy today!
Coding for care on the clock
Take time to clarify the midpoint rule, review CMS’s proposed guidelines for Evaluation & Management, and ask why you’re being instructed to change billing codes.
Coding for repacking wound care and diabetic shock
Coding expert Bill Dacey explores coding for ongoing wound care and unexpected, extended care for a diabetic patient.
3 easy steps to identify undercoding
Untap hidden revenue and stop leaving money on the table by reviewing your Evaluation & Management coding.
Establishing ‘contact’ under transitional care management codes
Is a phone message sufficient to use the TCM coding series? Plus, guidance on advanced care planning codes.
Communicating problem status in the assessment and plan
This month's coding questions tackle the issue of problem “status,” TCM codes, and "quality" coding.
Coding Medicare Annual Wellness Visits Along with a 99397
Coding expert explains why we don't typically see a 99397 and an AWV, and why Medicare discourages this from happening.
Coding for Vitals: Is It Necessary?
In this month's coding column, our expert answers whether or not you need to include vitals when coding a patient encounter.
Payer Demands on a New Code are Unknown
In this month's coding column, expert Bill Dacey says requirements around the new code 93793 are unknown.
Coding for Annual Wellness Visits
This month's coding questions look at coding for transition of care for a nursing facility patient and on Annual Wellness visits.
Updating Your Fee Schedule: Now Is the Time
It's the time of year to update your fee schedule. Do you know where to find your contracted rates?
Medical Coding in a Consulting Capacity
This month's coding questions look at the difference between a 99243 vs 99244 in a consulting capacity.
Coding for Advance Care Planning
What do practices need to know about coding for advance care planning? Here is some guidance from the AAPC's John Verhovshek.
Hypertension Coding in the Age of Quality
How do physicians need to manage hypertension - from a coding perspective - in the age of quality-based care?
Coding Questions: Billing a Physical During a Follow-up
This month's coding questions include what to do with the ROS section of the EHR and whether or not to bill a physical during a follow-up.
Knowing Payers' Rules Can Save a lot of Money
Did you know that your insurance payers have very specific rules that you are required to follow? Don't leave money on the table.
Coding Questions: Definition of Direct Contact
Coding expert Bill Dacey answers questions on the correct definition of 'contact' and the 'mid-point rule' during a medical visit.
How to Choose Between Modifiers 25 and 57
When do you use modifier 25 or 57? Coding expert John Verhovshek explains the difference when coding an E&M service.
A Plan of Attack on Getting What You Owe from Payers
Your team of physicians, administrators and lawyers can help you get what you rightfully owe using data-driven tools.
You Should Worry about Medical Coding Guidelines Changing
E&M coding guidelines are finally changing after 20 years, but don't celebrate yet. These changes may be worrisome to practices
Inventing New Medical Billing Codes
What happens when a patient presents with a condition that there is currently no billing code in the system for? This doctor finds out the hard way.
2018 Coding Updates: Vaccines, Consult Codes
Coding expert Bill Dacey has some of the most recent updates to the coding manual. What do you have to know for 2018?
Doc in Over His Head with Medical Coding
This doc found out the hard way that medical coding for a single patient can be a cumbersome time suck.
Building a Medical Coding Team: In-house vs. Outsourced
Should you hire an in-house coder or outsource? Do you need to hire one at all? Answers to these questions and more.
Documenting in the EHR and Focusing on the Patient
Physicians need to document care in the EHR, but they can either keep the computer out of the room or embrace it to focus on the patient.
5 Must-see Coding Strategies for your Practice
The coding rulebook is always changing. Here are strategies from our two coding experts to help you stay compliant.