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2018 CPC Practice Exam Answer Key 150 Questions With Full Rationale (HCPCS, ICD-9-CM, ICD-10, CPT Codes) Click here for more sample CPC practice exam questions with Full Rationale Answers

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Medical Billing Company

Health care professionals are so occupied in patient’s treatment that they do not have time or energy to do their billing job. But they cannot neglect this sector of their practice, as cash turnover is the key to success of a practice. Cash will flow smoothly only if the billing is done accurately and on time. Some companies have come up with a solution to health care professional’s billing problem. These organizations are called medical billing companies.

Medical billing is a meticulous job which needs accuracy and attention to details. Billing companies employee skilled medical billing professionals to do the billing related jobs. So, health care facilities are never at risk. Medical transaction companies are located world wide. When a billing job is outsourced to a company located in a developing country, it is a very cost effective business for the health care facility.

One of the main advantage of outsourcing the billing job is time saving. Billing is a time consuming procedure. Since this is done entirely by a third party, doctors are able to concentrate on their main job; patient’s treatment. Out sourcing has reduced the burden on the back office staff. So, the need of resources has greatly reduced. Medical billing companies process the claim using electronic billing software. When software is used in billing, the errors are reduced and claims are processed in a very fast and efficient manner. This helps in quick turn around of the cash. Most of the companies use software that is HIPAA compliant and billing is done using state-of-the-art network. This is highly essential to prevent the fraud happening in the billing.

There are many companies out there to provide billing service. The main goal of these companies is to maximize the reimbursement in a speedy timely manner. So, hiring a right medical billing company will significantly improve the profit of the health care facility.

Medical billing companies charge their clients for the service they provide. They either take a percentage of the reimbursed amount or they charge for the number of claims they processed. In either way, it is a very cost effective to the doctors. This helps in saving money by avoiding staff payment and benefits, software purchase, printing, posting and other inventories required in billing.

So, handing over the billing procedures to the medical billing companies significantly improves the clinical, financial and administrative performance of the health care facility.

There are allot of different kinds of Medical Billing Companies available for you to choose from when trying to find a career doing Medical Transcription from Home.

Demand For Medical Billers

The high demand in the job market allows a medical billing professional to earn competitive salary. Medical billers can earn either full time income or part time income. That is the advantage of being in the medical field. It gives the flexibility of working anywhere and anytime of the day. This is possible with billing because the equipments required to work are a computer with medical billing software.

As per the study, medical billers bring home around $ 20,000-$ 40,000 annually. The wage depends on several factors such as job experience, education, the organization they work for and which part of the United States, the organization is located. Like all the other jobs, skilled and experienced billers enjoy a good salary. Their earnings are somewhere around $ 14-$ 16 per hour. A skilled biller should be self-motivated, have good follow-up and should be able to give importance to the minute details in a patient’s file. Experience is not the only criterion that affects the wage but the responsibilities the medical worker handles also plays a role.

Even though certification, diploma or associate degree is not a prerequisite for medical billing, the salary a biller earns increases with the amount of training. Medical billing and coding are correlated. So a professional who knows both earns better compared to person who knows only billing.

Medical billing professional who works in the hospitals or other health care organizations earn a fixed salary as an in house employee. But those who work from home can work for multiple clients. So their salary depends on how many clients they handle. People who work in California, Chicago, New York, Boston, Houston and other big cities are paid more. This is basically because of the high cost of living in these cities or states. When it comes to the job opportunities, people should be aware of the scams. They may sound very legit. They promise people more than they can provide with and charge hefty amount for that. Sometimes they even try to sell their products such as expensive software. But finally when the candidates hand over the money, they get no job. So, it is better to make sure that those companies have real clients, not just fabricated list of clients. In order to make sure that they have real clients, candidates should always ask for references.

Medical billing job is very demanding and at times it can be very hectic. If someone can handle these and enjoy a promising salary, medical billing is one of the options.

Medical billing and coding classes are the first step you need to take to complete all your medical billing training for certification.

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Medical Billing Schools – How to Find the One For You

Medical billing and coding is a fast growing industry. Many people are searching for a career as a medical billing and coding specialist. Physicians and medical practices look to people specializing in such careers to take care of their needs. There are many schools emerging across the US and Canada to help meet the high demand for these types of specialists.

Once people have completed their training, they are often met with offers from physicians, hospitals, private health care facilities and health insurance companies. This is just one of the needs these graduates fulfill. The can also become employed as medical records administrators and medical office managers or facilitators. Generally, a certificate or diploma is given upon completion of the course. These people are trained in medical billing as well as how to deal with physicians and insurance companies. These are important aspects of the career and ensure the job will be done accurately and precisely.

In order to begin your studies at a medical billing school, you must begin with a high school diploma. Experience in the health care arena is also a good idea. Just like any other college degree, those who pursue a medical billing career are required to have all of the skills that are necessary to do the job upon graduation. Some additional skills the course should be able to expand on are:

Medical Terminology
Chemistry
Biology
Anatomy
Medical Law
Ethics
Data Entry
Computer Operation

Many people who are considering pursuing this type of career are adults. They are employed full time during the day, therefore, many medical billing schools offer classes at night or on the internet. This shortens the time it takes to become certified to a matter of weeks in some cases.

Upon successful completion of one of these programs, you can expect a professional degree such as Associate of Arts (AA), Associate of Science (AS), or Associate of Applied Science (AAS) degrees.

Know what type of certification or degree is offered before you decide on a school. This can be an important deciding factor in where you choose to begin your career certification. Be sure that the school you choose offers classes that work with your current situation. If you are employed full time, you will most likely want to keep your current position while attending school. There are many options available for someone looking for a good medical billing school.

George Edmondson is an accomplished writer on Medical Billing Schools. For more information on Medical Billing Schools please visit http://www.thebillingupdate.com

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Medical Malpractice For South Carolina

The vast majority of medical and health care providers including primarily hospitals, surgeons, doctors, pharmacists, physicians, nurses and emergency medical technicians (“EMTs”)do offer excellent care that will help us to recover from a personal injury or medical condition. However, some providers fail to meet the requisite standard of care, and, under such circumstances, may be guilty of medical malpractice. Medical malpractice, commonly called “medmal” for short, generally occurs when a negligent, careless or reckless act, mistake, error, or omission by a doctor or other medical professional causes damage or harm to a patient

 

COMMON TYPES OF MEDICAL MALPRACTICE

It has been estimated that almost 98,000 people die in hospitals in the United States each year, and that medication errors injure approximately 1.3 million people per year. Medical malpractice errors or negligence typically occur in the diagnosis or treatment of a patient, and may include, but are not limited to:

>Failure to treat
>Wrong treatment
>Delay in diagnosis
>Failure to diagnose
>Failure to rule out causes or conditions
>Misdiagnosis
>Failure to test
>Failure to obtain informed consent
>Surgical injury
>Wrong prescription of drugs
>Patient abandonment
>Use of defective medical products

A patient’s right to recover compensation for medical malpractice is generally governed by common law as well as statutes and regulations which have been promulgated to protect patients who have been subjected to medical malpractice or medical negligence. Medical malpractice suits are usually complex, time-consuming, expensive to litigate, dependent upon expert testimony, and vigorously defended by health care providers and their insurers.

 

ELEMENTS OF A MEDICAL MALPRACTICE OR MEDICAL NEGLIGENCE CLAIM

The medical malpractice personal injury victim is commonly referenced as a “plaintiff” and the person or entity that caused the harm is commonly referenced as a “defendant.” The South Carolina Supreme Court has set forth the elements of negligence with regard to a medical malpractice personal injury claim that a plaintiff has to prove as follows:

>A physician-patient relationship exists
>The generally recognized and accepted practices and procedures that would be followed by average, competent practitioners in the defendants’ field of medicine under the same or similar circumstances >That the defendant departed from the recognized and generally accepted standards
>The defendant’s departure from such generally recognized practices and procedures was the proximate cause of the plaintiff’s alleged injuries and damages

 

Thus, the medical malpractice lawyer and his client must present evidence to meet each of the foregoing elements at trial.

A physician commits malpractice by not exercising that degree of skill and learning that is ordinarily possessed and exercised by members of the profession in good standing acting in the same or similar circumstances. Durham v. Vinson, 360 S.C. 639 (2004). A plaintiff and his attorney must proffer expert testimony to prove both the required standard of care and the defendant’s failure to conform to that standard, unless the subject matter lies within the ambit of common knowledge so that no special learning is required to evaluate the conduct of the defendants.

 

INFORMED CONSENT CLAIM

A physician’s failure to obtain a patient’s “informed consent” with regard to a procedure or treatment is a form of medical malpractice. The term “informed consent” means that a physician must tell a patient all of the potential benefits, risks, and alternatives involved in any surgical procedure, diagnostic procedure, medical procedure, therapeutic procedure, or other course of treatment, and must obtain the patient’s written consent to proceed. Under Informed consent law, a physician who performs a diagnostic, therapeutic, or surgical procedure has a duty to disclose to a patient of sound mind, in the absence of an emergency that warrants immediate medical treatment, (1) the diagnosis, (2) the general nature of the contemplated procedure, (3) the material risks involved in the procedure, (4) the probability of success associated with the procedure, (5) the prognosis if the procedure is not out, and (6) the existence of any alternatives to the procedure. Thus, the plaintiff and his lawyer must present evidence of the physician’s breach of the foregoing elements of an informed consent claim in order to prevail at trial.

 

BREACH OF CONTRACT OR WARRANTY CLAIM

While most health care providers will not guarantee or warrant a particular outcome, there are times when they do, and a failure to successfully provide the outcome may give rise to a breach of contract or breach of warranty claim. These type cases usually involve plastic surgery wherein the patient is told that his or her post-surgery physical appearance will be the same as demonstrated on a computerized enhancement of the patient’s photograph. Thus, much like a business breach of contract claim, the plaintiff and his lawyer must present evidence of the physician’s breach of the stated warranty or guarantee by the preponderance of evidence in order to prevail at trial.

 

COMPENSATION IN MEDICAL MALPRACTICE CASES

In a medical malpractice personal injury lawsuit, a victim seeks compensation for the injury or injuries he or she has suffered. Compensation can include past and future medical expenses, disability or deformity, loss of income, emotional and mental anguish, loss of a spouse’s comfort and society, past and future pain and suffering, and an amount which would be necessary to make the person whole as respects a permanent personal injury. McNeil v. United States, 519 F.Supp. 283 (D.S.C. 1981). In cases where the defendant acted recklessly, maliciously or willfully, punitive damages may also be awarded. Punitive damages in medical malpractice lawsuits are intended to punish the responsible party and deter others from committing the same acts. Gamble v. Stevenson, 305 S.C. 104, 406 S.E.2d 350 (1991). If a wrongful death results from the medical malpractice, the decedent’s beneficiaries are entitled to compensation.

 

CAPS ON MEDICAL MALPRACTICE DAMAGES

For medical malpractice cases arising on or after July 1, 2005, which placed caps on non-economic damages a patient could recover from a liable defendant health care provider. S.C. Code § 15-32-220(a) limits the civil liability for non-economic damages of the health care provider to an amount not to exceed $ 350,000 for each claimant regardless of the number of separate causes of action on which the claim is based. S.C. Code § 15-32-220(a) provides an exception to the foregoing cap where the health care provider is proven to be grossly negligent, willful, wanton or reckless and that conduct was the proximate cause of the claimant’s non-economic damages. S.C. Code 15-32-220(b) provides that the $ 350,000 cap is limited to each claimant. S.C. Code 15-32-220(c) allows a claimant to stack his claim, and provides that up to three health care providers may be subject to the $ 350,000 cap per claimant, for a total of $ 1,050,000 per claimant.

 

The non-economic damage cap of $ 350,000 per medical entity or practice or person does not apply to economic damages and does not apply to punitive damages. Effective for medical malpractice cases arising on or after July 1, 2005, S.C. Code 15-32-230 further limits liability with regard to emergency obstetrical or emergency department situations. This section eliminates liability on behalf of any person providing emergency care or emergency obstetrical care to a person in immediate threat of death or an immediate threat of serious bodily injury while in an emergency room, obstetrical or surgical suite, unless the health care provider is proven to be grossly negligent. Other caps or limitations may be applicable to a medical malpractice case as well.

 

STATUTE OF LIMITATIONS

The plaintiff’s attorney must timely bring a medical malpractice suit within the required timeframes. There are time limits on bringing a personal injury lawsuit in the state of South Carolina known as statutes of limitations. See S.C. Code 15-3-530(5); 15-3-535. While a medical malpractice personal injury suit is generally subject to a three year statute of limitations, there may be exceptions depending on the circumstances, such as a medical malpractice case where the negligent conduct may be covered by a concept known as the “discovery rule.” See S.C. Code 15-3-545; Wilson v. Shannon, 299 S.C. 512, 386 S.E.2d 257 (Ct. App. 1989).

 

The statutes of limitations are different for negligence suits against a South Carolina state government agency pursuant to the South Carolina Tort Claims Act (“TCA”) and the federal government pursuant to the Federal Tort Claims Act (“FTCA”). Under the TCA, a suit must generally be filed within two years, unless a verified claim is filed within a year of the injury, then the statute of limitations is three years. S.C. Code § 15-78-110. Under the FTCA, an administrative tort claim must generally be presented to the subject federal agency within two years. Once a timely administrative tort claim has been filed, there is no statute of limitations on bringing a suit unless the federal agency denies the claim, in which case a suit must be brought in federal court within six months after the denial. 28 U.S.C. 1346(b), 1402, 2401, 2675.

 

NECESSITY OF AN EXPERT

South Carolina Code 15-79-125 requires, on medical malpractice cases arising on or after July 1, 2005, that before a medical malpractice suit can be filed, a plaintiff has to simultaneously file both a notice of intent to file suit and an affidavit of an expert witness subject to the affidavit requirements established in 15-36-100 in a county in which venue would be proper for filing or initiating the action. Statutory mediation of any such medical malpractice case is required as well, and, there are time limits for filing suit should the attempted mediation fail. As noted above, an expert’s testimony is necessary at trial to prove a breach of the standard of care and proximate cause of the injury, and the medical malpractice lawyer should retain a medical expert early on to assess the case and to be prepared to testify at trial.

 

Medical malpractice suits in South Carolina are difficult to pursue. Before undertaking a med-mal suit, the injured client would be well advised to consult with a lawyer with medical malpractice experience.

 

Joseph P. Griffith, Jr., Esquire
Joe Griffith Law Firm, LLC
7 State Street
Charleston, South Carolina 29401
(843) 225-5563 (tel)
(843) 722-6254 (fax)
http://www.joegriffith.com

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Medical transcription is usually done by a medical transcriptionist

Medical transcription is a clinical process. It is a process wherein an audio format is converted into the text format. The entire process can be explained like this. When a patient goes to see a doctor, he goes there because he is not feeling well. The doctor then asks him certain questions regarding his heath. He also asks him about various health disorders he had in the past and his family history about diseases. Through this the doctor can know what is wrong with the patient. All this information the doctor records in an audio tape which is then converted into a text format so that the doctor can store it properly. This is known as medical transcription. Transcription India is also done in this manner only.

Medical transcription is an allied health profession. It can be carried out by individual doctors, medical institutions, clinics, medical colleges and hospitals. Medical transcription is carried out in various medical fields namely- gynecology, surgery, psychology, neurology and dermatology. It is also important in the physiology and oncology department for maintaining various records of the patients. Transcription India is hence very important in various fields of medicine.

Medical transcription is important for doctors. It helps them remember the vital information about patients and their past illnesses and symptoms.

Medical transcription is done by Medical transcription companies. These companies work on outsourcing. They recruit medical transcriptionists for this. Also because of the latest technological developments, medical transcription is undergoing a lot of change.

Medical Transcription is usually done by a medical transcriptionist. They are usually science graduates who possess certain information about medical terms and terminologies. They should be able to verify and check the numbers. They should have a good amount of knowledge about how to maintain and store documents for future easy reference.

Medical transcriptionist requires certain skills. They have to adept at hand eye coordination. They require fast typing movements; hence they should be very quick. They should be capable of understanding the written and verbal communication. Also they should be very skilled in communicating with others, especially doctors since it is an outsourcing job.

Acroseas is a global provider of Transcription services & has been providing top-of-the-line transcriptions services to our clients worldwide. For more info – please log onto www.acroseas.com

How to Work From Home Doing Medical Billing and Coding!

If you’re thinking about doing medical billing and coding and working from home there are a few things you want to know. First of all do you have the ability or skills or training in order to be able to process claims for doctors, dentists or large clinics.

To process claims at home you’ll either have to be in business for yourself or make some arrangement with your employers to work at home. The employer in this case would be the doctor, dentist or other health professional or clinic that needs medical billing service. This may be difficult to do if you haven’t had the proper training and don’t have the right medical billing software.

Many people who do work from home doing medical billing and/or coding generally have their own business. They have started home businesses after getting the right training. (Coding requires separate training and certification may be required by some employers.)

It would probably be difficult to get on-the-job training and more than likely you’ll have to get training through online courses, programs or schools or on campus locally where you live. There is a national exam for certification as a Medical Billing Specialist that would probably be required by most companies seeking your service. Plus after you get some training you’ll want on-the-job experience so you can learn the ropes. You want to know what you’re doing before you work alone at home.

So one of the things you can do is call some of the clinics in your area and find out whether they do their medical billing and coding in-house or whether they send it out to a billing service. If they do it in-house, ask if they hire people to do additional billing for them at home either by contracting out to you or hiring you to work at home and they would act as employer. There may be a lot of variation in practices in different geographical areas. So best to call and see what you can find out.

So now you may know a little bit more about whether you want to work from home doing medical billing and coding. When you do decide that you do need some training, there is federal government money available for online courses as well as on-campus. So you want to check out medical billing training online and local colleges. Be careful of any scams that may be operating. Read the fine print and don’t sign up for any courses you don’t need.

For secrets and tips on how to start a medical billing business or as a career, choosing the best medical billing training, finding the best medical billing business schools, online courses, college, work at home and financing go to a nurse’s website: http://www.MedicalBillingTrainingInfo.com

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Advantages Of Outsourcing Medical Billing

Medical billing and coding constitute one aspect of the healthcare services that usually takes a lot of time from healthcare providers. Many healthcare providers complain about time management. As much as they want to focus on providing services to their patients, a lot of their time is often given to processing medical bills.

That is why many medical billing companies are now in the industry to help healthcare providers with the process of medical billing. In a medical workplace, it has been difficult enough for health practitioners to stretch out their time in treating their patients ailments. Its probably the reason why there are some health practitioners that do not accept health insurances.

In order for health practitioners to provide service, they need to run a business. Although its not part of their nature, doctors need to earn money to continue their operation. Medical establishments need to earn money to pay their bills and their employees. The reason why many healthcare providers are outsourcing medical billing services is because it provides them advantages aside from getting their bills on time.

Availability

There are many medical billing companies that offer medical billing services and software applications all over the country. One advantage of these companies is that they extend their coverage by catering to different medical professions such as dentistry, cardiology, pediatrics, dermatology, and many more. These medical billing companies also offer a variety of services aside from organizing billing payments.

Reducing cost while improving cash flow

Cash flows are the foundation of many business entities, and healthcare professions are considered as a business at some point. By hiring medical billing companies, healthcare providers do not need to hire full-time accountants to manage their billings. This helps them save money from paying salaries and work redundancy. They will be gathering bills and payments that are important in fueling the business. Bills are automated, which means that doctors will receive payments on a regular basis.

Focusing on the cores

Probably the most important benefit of hiring medical billing companies is that it allows health practitioners to focus on their profession. Doctors do not need to mind how they will be paid. Instead, all they have to do is provide healthcare to their patients and get paid on a given time.

For More Information, please visit our website at www.MedicalBilling4U.com.

Gastroenterology coding update: Ensure tube changes claim success

When your gastroenterologist deals with any of the various types of gastrointestinal (GI) tubes, you should examine how he carried out the proceudre to the patient to determine the right CPT codes.

Gastrointestinal procedures contain three main types which are initial tube placement, tube placement, and tube maintenance. Each provides a unique set of guidance that calls for a different coding approach. Follow it to a T, and you will always be safe. Here’s what our experts have to say.

Choose proper ‘initial’ gastrointestinal tube placement code

If your gastroenterologist carried out an initial, percutaneous insertion of a gastrostomy tube, without using an endoscope and including radiologic supervision and interpretation, report 49440.

In this procedure, the gastroenterologist creates a puncture through the patient’s abdominal wall from outside the body, and inserts a device under fluoroscopic or ultrasound guidance. This allows the doctor to pull the stomach up to the abdominal wall and then insert the tube percutaneously without using an endoscope.

Flashback: Earlier, you would report this procedure using 43750. However in 2008, CPT deleted this code. Its replacement 49440 covers all of the components to place the tube, including the associated imaging procedures.

Watch your ‘maintenance’ procedures

For maintenance services, you should familiarize yourself with another set of codes which includes 49460 and 49465.

Remember that codes 49440-49442, 49450-49452, 49460, and 49465 all include fluoroscopic guidance.

For more gastroenterology coding update, sign up for an audio conference. When you sign up for one, you’ll have access to all gastroenterology coding update under one roof. The best part of attending such an audio conference is that you can listen to it from the comforts of your own office. Even if you miss out on a scheduled gastroenterology coding conference, you can always fall back on CDs and MP3s to take you through the entire event. You even stand to acquire CEUs on attending one.

Audioeducator offers medical coding audio conference and provides advanced Learning Opportunities about medical coding update through all types of audio conferences and exceptional series of training CD’s, DVD’s & Tapes.

Three Pointers To Help You Avoid Common Stent Coding Mistakes

When your urologist places a stent after a ureteroscopic procedure (say for instance stone removal, the coding is not always cut and dry. You will need to dig into the documentation details to ensure you select the proper code for the clinical circumstances.

Here are three pointers which will help you stay away from the most common stent coding mistakes.

Get to know when the stent is not really a stent

Not each and every mention of stent’ in your urologist’s documentation means you can report a stent code such as 52332 (Cystourethroscopy, with insertion of indwelling ureteral stent [e.g., Gibbons or double-J type]).

Here’s the reason: There are two types of stents your urologist will make use of temporary and permanent and the first one is not really a true stent. A temporary stent is in actuality a ureteral catheter, placed at surgery to assist during surgery. The urologist then removes the catheter post surgery before the patient leaves the operating room. In this situation, you should not report stent code 52332. Instead, use 52005 (Cystourethroscopy, with ureteral catheterization, with or without irrigation, instillation, or ureteropyelography, exclusive of radiological service).

For postoperative drainage stents, stick with 52332

The second type of stent is a permanent stent. These types of stents are placed after surgery for drainage, and are indwelling and self retaining. The patient goes away from the operative room with the stent in place, and the stent will be removed at a later date.

Whereas temporary stents that are often placed as part of an endoscopic procedure (52320-52355) can’t be reported in addition to the primary procedure, an indwelling stent, which is placed during the procedure to keep the ureter open and to aid recovery after the procedure can be billed separately.

Here’s how: When your urologist documents that he placed a double-J stent for postoperative drainage, you should use 52332.

Bilateral coding: If your urologist places bilateral double-J stents for postop drainage, your exact coding will depend on the payer. For Medicare, use 52332 with modifier 50 (Bilateral procedure) appended. Private payers may also want 52332-50 or they may request you use 52332-LT (Left side) and 52332-50-RT (Right side) on two lines.

In many instances, report stent placement separately

If your urologist places a stent during the same session in which he also carries out another ureteroscopic procedure, most likely you can report both procedures.

When the patient has a large ureteral stone which the urologist removes ureteroscopically, there may follow a significant amount of ureteral swelling. In order to avoid complete ureteral obstruction, an indwelling ureteral stent may be placed to keep the ureter open.”

In this situation, bill the ureteroscopy code (52352, Cystourethroscopy, with ureteroscopy and/or pyeloscopy; with removal or manipulation of calculus [ureteral catheterization is included]) and 52332. For some payers you may need to add modifier 51 (multiple procedures) to 52332 to indicate that you have carried out a secondary procedure. You don’t need to add modifier 59 (Distinct procedural service) as because 52332 is no longer bundled with 52320-52355.

For more on this and for other specialty-specific articles to assist your urology coding, sign up for a good Medical coding resource like Coding Institute.

The Coding Institute is dedicated to offering quality products and services to help healthcare organizations succeed. We are primarily focused on providing specialty-specific content, codesets, continuing education opportunities, consulting services, and a supportive community of healthcare professionals and experts.

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Make Perfect your ICD-9 Coding Skills

You can get increased payments when your ob-gyn provides additional visits outside of the normal global ob package; however you’ll have to ensure you have coded high-risk or complicated obstetrical care correctly – and that means perfecting your ICD-9 coding skills.

Be firm on perfect ICD-9s

To demonstrate the reason for the additional service, you have to link the ICD-9 code on the CMS-1500 claim form (boxes 21 and 24E) to an E/M code. You can add this to the claim that includes the global service or you can submit it as an additional claim.

Here’s an example: A 33-year-old patient, gravida 3, para 2 (both normal spontaneous vaginal delivery [NSVD] full term), is tended to 19 times due to developing pre-eclampsia. Post delivery, you review the case and find that the patient required six additional visits (beyond the usual 13) for this care. The documentation for three of these visits supports reporting 99212 while three of the visits have more extensive documentation that supports reporting 99213.

To add to it, post delivery, the patient experiences prolonged pain and irritation owing to a hemorrhoid. The ob-gyn tends to her for a thrombosed hemorrhoid, which he incises in the office two weeks post-delivery. In the end, the ob-gyn rechecks the patient at her six weeks postpartum visit.

Break it down: When coding for this patient, remember the claim form must note both the CPT codes describing the additional services as well as the diagnoses that depict why the patient required the additional services.

Heads up: Observe the fifth digits of these ICD-9-codes. The digit ‘3′ that takes place in most of these codes has become a ‘4′ in the last ICD-9 code to indicate a postpartum condition rather than an antepartum one. In other words, the patient has been discharged from the hospital after giving birth. Using ‘3′ indicates she did not deliver during the hospital stay.

To add to it, after delivery, the patient experiences prolonged pain and irritation owing to a hemorrhoid. The ob-gyn sees her for a thrombosed hemorrhoid, which he incises in the office two weeks post delivery. In the end, the ob-gyn rechecks the patient at her six weeks postpartum visit.

We provide you simple, instant connection to official code descriptors & guidelines and other tools for 2010 CPT code, HCPCS lookup that help coders and billers to excel in the work they do every day.