Hello, new to ob/gyn coding and this has me stumped. CPT 58671 is a bilateral code. If only the right fallopian tube is occluded via band is it coded as 58671-RT. Does it matter if the payor is Medicare or Commerical? Coding for a facility and not a physicians office. Thank you.
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Tag Archives: Side
50240 twice on same side ?
My physician wants to bill 50240 twice on the same side because he resected two different areas of the same kidney for tumors. One in the upper pole and one in the lower pole. Does any one have any guidance on this ?
Thank you.
Thank you.
Acai Berry Diet – Medical Side
When you take a look at many of the dietary crazes that have swept through the internet, many have turned out to be scams on one level or another. At the very least, each one was guilty of embellishment bordering on false advertising. Given that particular fact, it is no wonder that many people are nervous about the acai berry diet.
That having been said, the nervous people are overlooking one fact that makes the acai berry and subsequent acai diet plans that are based on it quite a bit different from just about anything else available in online weight loss. That fact is that the acai berry is backed by some serious science and is also backed up by thousands of years of history in South America where civilizations have used it for some time.
On the medical side of things, the acai berry diet has been looked at by doctors, life scientists, kinesiologists and health scientists, all of whom have agreed that this little berry is one of the most remarkable foods around. In fact, many of them have become quite enthusiastic about it, even to the point where many family doctors are now recommending it as a way for some of their patients to deal with problems outside of the realm of general weight loss.
This point is worth emphasizing, because most people may now know exactly how the scientific community works. When something is big, scientists get major credibility points if they are able to demonstrate something that runs counter to the prevailing theory. Essentially, this means that scientific inquiry is set up such that scientists have much more to gain by disproving something than by proving it. In other words, scientists have no interest in making anything look good, yet they are coming out with glowing reports about the berry and corresponding acai diet plan.
The only way that this could be true is if the acai berry diet was a legitimate diet that really helped people lose weight and keep the lost weight off. Otherwise, it would be torn down by the medical community and be relegated to the scrap heap of online weight loss products, something that appears like it won’t be happening.
Dana Hawkes is a Acai berry diet expert, explaining everything about it on her acai berry blog on http://www.acaiberrydietnow.com This is the one prime source to visit about acai berry diet More then 100 articles, so start reading now!
Related Medical Coding Articles
Bilateral procedure- one side discontinued
I’m hoping to get an opinion on the correct coding for this. Physician performed 64483 bilaterally on one level, however, had issues and could not complete the left side. It was billed as 64483-RT, 64483-53-59-LT. Medicare paid the right side, but denied the left as information submitted does not support this many/frequency of services. Documentation was sent, but it still denied.
I thought about changing the left to 64484-53-LT, although the definition of 64484 is for each additional level and this was the same level as the right side. The only other thing I can think of is to bill the bilateral as 64483-53-50, but I wasn’t sure if the completed side would get paid at the full rate if I do this.
Thanks!
Susan
What is immunotherapy and can it cause some side effects?
Please explain what is immunotherapy and does it have any side effects? Also, there are several types of Immunotherapy. How are they different and used?
How an RMC Credentialed Coder Can Enhance the Business Side of Any Physician Practice
Long gone are the days in which physician practices could rely on a single office manager to oversee operations and perform the coding and billing. Today’s practices are under an almost unfathomable amount of scrutiny by auditors and payers, requiring a highly specialized knowledge of the healthcare system. Couple that with electronic medical record (EMR) implementations, the Affordable Care Act, and the recent transition to ICD-10, and you’ll find that many practices are struggling simply to stay in business. In fact, many practices have joined larger groups, hospital networks, or Accountable Care Organizations because of the option to share compliance risk and resources among various participants.
ICD-10 and other regulatory requirements have also inspired a trend toward hiring credentialed coders who can help physician practices navigate regulatory changes with ease. Physicians are beginning to realize that selecting a code in ICD-10 is not a straightforward task. Physicians must choose from among hundreds of codes in an EMR dropdown menu. Even the narrative descriptions for many of these codes differ from their ICD-9 counterparts. Physicians either take the time to choose a correct and specified code—and therefore lose precious productive time—or they simply choose the first code that pops up regardless of its accuracy or specificity. Neither of these scenarios is good for the business side of the practice.
Gaining a financial peace of mind
In a post-ICD-10 world, certified coders provide an added layer of financial security by:
• Validating code accuracy and specificity, which can, in turn, ensure accurate reimbursement and outcomes reporting
• Determining whether documentation supports code assignment (i.e., Do clinical indicators and other details documented in the record match the code assigned?)
Once this information is verified, billers are able to submit a clean claim with a lower likelihood of denial. Without this added level of review, practices run the risk of sending bills that are subsequently denied and that must be appealed or written off.
In addition to promoting accurate code assignment, certified coders also enhance these other business processes within the practice:
• Clinical documentation improvement (CDI). CDI serves as the backbone of a practice, ensuring that patient severity and complexity is captured within the documentation.
• Compliance. Certified coders establish ongoing internal audits that target E/M code assignment, diagnosis code assignment, and other high-risk areas identified by the Office of Inspector General and Recovery Audit Contractors.
• Training and education. Certified coders provide training for all physicians and other staff members about important regulatory and coding changes, keeping everyone one step ahead of auditors.
• Process improvement. Using data analytics and other tools within the EMR, certified coders monitor denials and identify/address the root cause of any problems. This is critical in ICD-10.
Looking for the right credential
Various organizations offer coding credentials and certifications; however, MMI’s Registered Medical Coder (RMC) credential is the only one in the industry that requires an annual retest to ensure ongoing competence. The retest measures coders’ knowledge of important CPT, HCPCS, and ICD-10-CM code changes that affect all specialty areas the majority of practices. An RMC-credentialed coder must also meet these requirements:
• Passing score of 76% or higher on the initial certification exam. Note that this is more stringent than any other coding certification industry standard.
• 12 CEUs annually.
• Ability to demonstrate proficiency working in an online environment. MMI’s courses and certification exams are entirely online.
MMI’s stringent standards for coding certification directly benefits physician practices seeking to maintain the highest degree of compliance. RMC-certified coders are able to identify areas of coding and documentation improvement and articulate important industry changes and their potential effects on the practice. By enabling prospective—rather than retrospective—compliance, RMC-certified coders enhance operational and financial efficiencies. A practice that employs a certified coder is ultimately a more profitable and compliant practice.
About the Author
Dari Bonner, RMC, CCP, CHCA
Dari Bonner serves as the Chief Training Officer at the Medical Management Institute (MMI) where she is able to bring her 22 years of healthcare experience to the table. Dari has extensive consulting & project management experience, with her areas of expertise in both the public & private sector, hospitals, outpatient service centers and large & small physician practices.
About the RMC
The Registered Medical Coder (RMC) certification is ideal for medical coders & billers in the physician office and outpatient setting. The credential is licensed through the Nonpublic Postsecondary Education Commission (NPEC) and is administered online through the Medical Management Institute (MMI). MMI is A+ accredited through the Better Business Bureau (BBB) and has been in business for nearly 30 years. MMI offers online medical coding training to prepare for the RMC Certification Exam.
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