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.
Coding for Distraught Psychiatric Patients
Can you code when a patient is so distraught an appropriate history cannot be obtained, nor can a mental status exam be performed?
Vaccine Coding for Patients 19 and Older
How to institute vaccine administration codes for patients who are older than 19 years of age. Also, guidance on follow-up codes in electronic billing.
Coding Requirements for Transitional Care Management
Coding for TCM services should include global periods; dates of service; and correct documentation.
Making the Most of Transitional Care Management
TCM helps patients transition from the hospital to the community. Many physicians, however, miss deserved reimbursement because they lack documentation.
An Open Letter to Patients About Medical Billing
Patients can understand so little about their health plan that the billing department is automatically blamed when something goes wrong.
What States Make Patients Pay Out of Pocket the Most?
What state allows for almost 50 percent patient responsibility? Also, which services have the highest percentage of patient responsibility?
Coding for Coordination of Patient Care
Physicians who spend significant time coordinating a patient's care may realize reimbursement in several ways.
Medicare Consult Denials; Coding for Unusual Services
Our coding expert discusses what to do when Medicare denies a consult code; preparation for Medicare chart audits; and coding for unusual services.
The Case to Ignore "Incident to" Billing for PA Services
Here's why you should ignore "Incident to" Billing for PA services, which require a significant amount of additional work without a fair return in revenue.
Coding for Advanced Care Planning
Answers from our coding expert on questions regarding advance care planning; pessary cleaning; and identifying inclusive codes.
Payer-Based Audits are Often a Waste of Time for Docs
While some payer-based investigations into fraud might be based on actual patterns of abuse, most are just an attempt to recoup funds.
How Practices Are Faring with ICD-10 at Six Months
Was the fear and trepidation surrounding ICD-10 overstated or is the early success around a lack of denials only temporary for providers?
One Practice's ICD-10 Experiences at Six Months
Understanding Your Claims Denials
When you look at your cash inflow each month, are you disappointed? That's why it is so important to identify why your claims are being denied.
Improve Compensation by Documenting Prolonged Services
Proper documentation and reporting of codes for prolonged services allows providers to improve compensation for lengthy outpatient services.
Despite Minor Issues ICD-10 Rollout Is Smooth
Since the implementation of the ICD-10 coding system, most claims are processing smoothly and rejection rates have been minimal.
Changes to Incident-To Billing; Time-Based Coding
Answers from our coding expert on questions regarding incident-to billing; time-based coding; and specificity in ICD-10.
Spelling Out Medical Necessity; Duplicative Coding
Answers from our coding expert on questions regarding medical necessity; using the ROS for history of presenting illness; and duplicative coding.
Upcoding vs. Downcoding: Know the Difference
Wrongful Payer Denials: How to Handle Them Quickly
When you are wrongfully denied for a single code or entire claim, do you know what to do?
Modifier 58 vs. Modifier 79; Coding from Fourth-Year Residents
Answers from our coding expert on questions regarding bronchoscopy; modifier 58 vs. modifier 79; and fourth-year residents.
ICD-10 Poll Reveals Few Problems in Transition
Despite all the hoopla surrounding ICD-10, nearly half the practices polled by Physicians Practice had no problems in transitioning to the new code set.
Best Billing Strategies to Grow Revenue for Your Practice
Here are three best practices for large practices that need to increase billing efficiency and keep the revenue flowing.
ICD-10 Codes for the Christmas Season
‘Tis the season! Cartoonist Jon Carter reveals that a few Christmas and holiday characters and traditions are just well-disguised ICD-10 codes.
One Doc 'Pleasantly Surprised' by ICD-10 Transition
For many physicians like Theo Felts, a family practitioner in Overland, Kan., ICD-10 has been no sweat at all. In this Q&A, he discusses the transition.
Survey: How is ICD-10 Going at Your Practice?
Is your practice suffering with ICD-10 or has it been a smooth transition? Take a quick five-question survey and share your experiences.
How to Apply Modifier 58
Physicians should use modifier 58 to indicate a staged or related procedure that was planned in advance.
Set Your ICD-10 Goals for 2016
The ICD-10 transition will continue into the next year for practices. Here are some tips you’ll need to take in 2016.
Train Staff to Address ICD-10 Related Coder Shortage
With a dearth of coders thanks to the ICD-10 transition, some practices find that training current staff is the best way to get good coders.
15 Funny Fall ICD-10 Codes
Fall brings a new set of activities that may require new ICD-10 codes at your practice. Here's a list of 15 possible – and funny – autumn injuries.
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