Laureen shows you her proprietary “Bubbling and Highlighting Technique”
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Lesion excision coding may seem complex, but reporting excision of benign (11400-11471) and malignant (11600-11646) skin lesions can be mastered in five steps. Step 1: Measure First, Cut Second When assigning CPT® codes 11400-11646, you must know both the size of the lesion(s) excised and the width of the margins (the area surrounding the lesion […]
The post Lesion Excision: 5 Steps to Coding Success appeared first on AAPC Knowledge Center.
Proposed changes in the Medicare Physician Fee Schedule (MPFS) for 2019 will change proposed reimbursement single evaluation and management (E/M) rates. Here’s a way for medical coders to see how much the new routes may affect your workplace’s reimbursement. This exercise will also help you determine what to share with CMS during the comment […]
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Clinicians eligible to participate in the Merit-based Incentive Payment System (MIPS) have until March 31 to submit their 2017 performance data. Don’t risk losing -4 percent in Medicare Part B revenue in fiscal year 2020 — submit your quality data to the Centers for Medicare & Medicaid Services today! Click here for MACRA training on how to do submit […]
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CMS issued a warning to hospitals and other providers to tighten up cybersecurity and issued instructions to surveyors to discuss health IT during state agency survey visits.
An ICD-9 coding policy can keep your claims flowing smoothly; however you cannot just set it up and forget about it. Here’s how to establish a policy that’ll remain current and help you avoid headaches when auditors come calling.
Step 1: The first building block of a well-designed coding policy is to indicate that you adhere to the ICD-9-CM official guidelines for coding and reporting. If you don’t stay up to date with these standard rules, you could be in for trouble.
For details: The official guidelines are updated each year and are normally available shortly after the annual ICD-9 updates go public.
If you keep up on the rules in the official guidelines, you will not have to worry about being blindsided by any across-the-board ICD-9 coding changes.
Step 2: Establish your coding process, including who does the coding and how you make corrections.
Step 3: Describe how your coding staff will stay up to date and keep up their coding competencies. Staying on top of changes can be especially vital, whether to the official guidelines, payer requirements or the transition to ICD-10.
Important issue: Right sequencing is always a concern for medical coders. Selecting the most proper diagnosis helps ensure not only that your practice gets its proper payments but that your coding will stand up under scrutiny from auditors. The assessing clinician and the expert coder must work together to ensure the ICD 9 codes are listed as per the seriousness of the patient’s condition.
Step 4: Documenting your auditing process – including the percentage of charts you will audit for accuracy and how often you will conduct those audits. Internal auditing can help ensure your dermatology coding is spot on before your mistakes are traced in a costly audit from a ZPIC, RAC, or one of the other auditing entities.
Step 5: Weigh the accuracy of your dermatology coders. Paired with auditing, establishing an accuracy rate for your coders can help set the bar for your commitment for precise coding. If you want your coders to maintain a 95 percent accuracy rate with their coding, include this information in your policy.
Step 6: Keep polices up to date. Do not let your coding policy sit on the shelf and grow dusty. Ensure the effort to check your policy periodically to make sure it’s up to date.
Mistake: Do not write policies that attempt to address how you are going to code each particular diagnosis. General policies that address the methods you use to keep your coding spot on are more useful and workable.
Follow up: If you get downcoded in an audit related to your diagnosis codes, gear up to ask for a redetermination. If your coding is supported by clear clinical documentation and you have followed the proper guidance, be prepared to write an appeal stating why the coding is right and quote official guidance in that appeal.
Auditors are not necessarily coders and may not be aware of the rules that govern the practice of coding. Quoting specific sections of the official coding guidelines helps to show that you are knowledgeable and have coded right.
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.
The adage to ‘always report the most specifc CPT code’ could ensnare your estrogen receptor (ER) and progesterone receptor (PR) coding for breast cases. Here our experts help you sort out the difference between specific analyte and specific method to ensure you select the right code every time.
Reserve 84233 and 84234 for assays
If you are searching for specific codes when a surgical pathology report references estrogen and/or progesterone receptor testing, you should not miss 84233 and 84234. However are those always the correct choice?
The 84233 and 84234 definitions create a confusion for medical coders reporting ER/PR tests. The question is whether you must report 84233/84234 as the definitions specify ER/PR, or if you can in its place report a generic immunohistochemistry code such as 88342 for certain ER/PR testing.
Codes 84233 and 84234 describe laboratory tests for estrogen and progesterone receptors that use a biochemical ligand-binding assay method like dextran-coated charcoal assay. However most labs evaluate ER/PR using immunohistochemistry as clinical studies have consistently shown the superiority of immunohistochemistry over biochemical assay methods for ER/PR testing.
Watch out for immunohistochemistry (IHC)
When the lab method involves immunohistochemistry for tissue specimens like evaluating breast tumors for ER and PR status, you should look to the following codes to describe the service: 88342, 88360, 88361.
Although these code definitions are ‘generic’ in the sense that they do not specifically identify estrogen or progesterone receptors, you should report them for an ER or PR (or any other) immunohistochemistry antibody strain.
Differentiate qualitative/quantitative codes
Choosing among 88342, 88360, or 88361 calls for knowing whether the immunohistochemistry analysis is qualitative or quantitative and whether quantification uses computer-assisted technology or “manual” counting, including visual approximation. You might choose to go for any of these three codes for ER, PR, Her- 2/neu, Ki-67, or any of various other IHC analyses
Count antibodies
You should report one unit of the right code for each antibody stain, irrespective of which antibody you are coding.
For more information on this and other CPT codes, sign up for a one-stop medical coding website. Such a site comes stocked with CPT codesets among other things.
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.
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It’s obvious that protecting patient information is of the utmost importance, but it’s getting harder and harder to do so in the digital world we live in.
Last year, 9 out of 10 physicians said they’ve transitioned to electronic medical records (EHR) and it’s estimated that by 2018 nearly of the 3.4 billion smartphone and tablet users will have downloaded some sort of health related apps, so it’s easy to see that there are several ways for patient information to be at risk.
Roughly 90% of health care organizations experienced a data breach in the last two years and there were 253 breaches last year alone, resulting in the loss of over 112 million health records. Now that we know there’s a problem, what can we do to stop it? I’m so glad you asked. Below you’ll find 7 simple steps to keep you and your patients safe!
Conduct an annual HIPAA security risk analysis to ensure that all storage tools are secure.
All data-at-rest and all mobile devices – including tablets – should be encrypted.
Physicians and nurses need to understand how to store and send data securely. In other words, use decent passwords, log out of networks when finished and avoid using personal devices.
All networks and servers should have remote wiping or remote disabling enabled.
All firewalls and security software should be kept up to date at all times.
Develop an incidence response plan in order to contain the damage and mitigate losses.
Develop a security strategy that’s customized for the particular data an organization stores.
The majority of these simple steps aren’t time-consuming, but go a long way in helping keep our patient data out of harms way. Be sure to check out the great infographic below by our friends over at UIC for more information. What is your company doing to protect you and your patients?
Be sure to check out the Online Master of Science in Health Informatics program from UIC!
— This post How Secure Is Your Healthcare Data? 7 Steps To Protect Patient Information was written by Manny Oliverez and first appeared on Capture Billing. Capture Billing is a medical billing company helping medical practices get their insurance claims paid faster, easier and with less stress allowing doctors to focus on their patients.
It’s all in how you dissect the operative report. Many coders struggle with coding operative reports because there are so many guidelines and policies that affect code selection. The process is easier when you break it into seven steps: Review the header of the report. Review the CPT® codebook (start in the Index). Review the […]
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