Since 2017 facilities have been using Modifier JW for reporting the wastage of a drug from a single-use vial or package prior to administration. Due to the fact that modifier JW was not being used correctly if at all, CMS (Centers for Medicare and Medicaid Services) provided clarification and education on the proper use of …
In this article we take a look at the importance of healthcare reimbursement for asymptomatic encounters. We will look at identifying primary diagnosis requirements that drive reimbursement, how to get paid for postoperative treatment visits and underutilized reporting when it comes to Social Determinants of Health. Medical Practices care for patients for a variety of …
Contributors: Chasity Speaks and Megan Johnson In October we raise awareness for Breast Cancer since it is the second most common cancer that women in the United States face according to the CDC. Every year in the United States, we see cases of about 264,000 in women and 2,400 in men. The mortality rate for …
Breast Cancer Awareness: Diagnosis, Treatment, and Getting Paid Read More »
How are you doing with your Lesion and Wound Repair Coding? Many Physicians across specialties perform skin procedures so it’s important that we understand the proper coding and documentation required. Knowing the guidelines for Lesion Excision and Wound Repair is crucial because at times they are bundled and the calculation methods are very different. Let’s …
Routine foot care is probably the most difficult thing for a Podiatry practice to manage. It takes a village to make sure all the proper steps are taken in order to get paid. This is because Medicare has a coverage policy that states the routine trimming of nails and removal of calluses or corns is …
It’s no secret that the most widely misunderstood and misused modifier in Medical Billing and Coding is Modifier 25. I have worked in the Revenue cycle for 20 years, and even in this day and age with so much education and easy ways to access regulatory guidance, many still misunderstand its use. Modifier 25: …
Did you know that Copay collections are required when you enter into a contract with an Insurance payer and that Routine Waiver of copays is against many Federal laws and regulations Including the Civil Monetary Penalties Law (CMPL), Anti-Kickback Statute (AKS), and the False Claims Act? Today we dive into the Laws and the regulations …
Episode 8: Stay Compliant with Copay Collections Read More »
Today we will discuss the various guidelines for reporting diagnostic services, Radiology Documentation requirements and Common Modifiers Objective: Section IV of the Official ICD10-CM Guidelines CMS IOM 100 Guidelines for Documentation LCD Policies Data Component of E/M Services Review
Today we discuss the Maze of Provider Credentialing and Important reasons to Credential your Facility and Provider with an Insurance company. Objective: Using PECOS and CAQH Importance of Payer Contract Negoatiations Updating Provider Enrollment Inhouse or Outsourcing Please see these helpful links mentioned in the podcast: PECOS Enrollment Checklist CAQH Proview Resources UHC Credentialing Information …
Today I will be talking about my career path and how to navigate your career path in a similar way. I give you my take on the main Coding Certifying Industries AAPC® and AHIMA®. I am certified in both and I love them both for what they offer to help coders and billers. Lets discuss: …
Episode 5: The Anatomy of the Medical Coding Career Read More »
