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Put Your ePrescribing Knowhow Into Meaningful Use

Posted on 10. May, 2011 by .


Get your system moving before June 30th or you’ll pay the price.

If you do not have an electronic prescribing (ePrescribing or eScribing) system yet in place, or have not integrated one into your electronic medical record (EMR) system, you better get a move on it. You only have until June 30, 2011 to submit at least ten claims to Medicare demonstrating that you are a successful eScriber for 2011. Otherwise, you are at risk of not only losing the bonus in 2011 but according to the rulemaking for 2011, also facing penalties assessed, reducing your Medicare fee schedule by 1 percent in 2012.

With limited time, it is smart to consider a stand-alone internet based system which you can implement relatively easy. You could get this system up and running right away, at a low cost,

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Look for Incision Evidence in Foreign Body Removal (FBR) Scenarios

Posted on 28. Sep, 2010 by .


Here’s why you should append modifier 25.

Question: A 47-year-old male reports to the ED complaining of a painful, swollen, and reddening right thumb. The physician performs an expanded problem focused history and examination, which uncovers two splinters. The ED physician cannot grasp the splinters with tweezers, so she uses a scalpel to make two small incisions above the splinters. The physician then uses tweezers to remove both pieces of wood. The notes do not indicate evidence of infection at the extraction site; medical decision making is moderate. Can I code this as a foreign body removal (FBR)?

Kentucky Subscriber

Answer: Since the physician made an incision before removing the splinters, this is an FBR. On the claim, report the following:

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Think You Understand the New Consult Rules? Find Out Fast

Posted on 28. Feb, 2010 by .


Test your 2010 consultation coding understanding with these questions.

Consultation coding has every practice on edge this year. Ensure that you’ve got a handle on this complicated coding and billing situation by trying your hand at this question.

Question: When a visit with a Medicare inpatient that would normally have been coded as a consultation does not meet the requirements of an initial inpatient hospital care code, what should you report?

Click ‘read more’ for answer …

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Collections: Banish Co-pay, A/R Problems

Posted on 07. Feb, 2010 by .


5 tips help you recover deserved pay.

Collecting money from patients, especially during a recession, can be challenging. If your front desk is responsible for collecting copays and sometimes old balances, its success or failure has a dramatic impact on the practice’s bottom line.

Check out five ways you can improve your front desk collection efforts:

1. When calling to remind patients about their visit date, also remind them of their co-pay amount and any old balances so they come prepared to pay at the visit.

2. When a patient complains about paying a bill, send her to a manager so the bill can be reviewed and explained.

3. Most practice management software will allow front desk staff to view outstanding balances. Your front desk staff can politely remind the patient that there is a balance and say something like, “How would you like to pay your bill today?” Assume…

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Why Is the Co-Pay I Collected Short By $20?

Posted on 06. Feb, 2010 by .


Verify co-pay early to save time, money

Question: A patient came to our office for a routine exam with the same insurance card she’s had for years. We charged her the standard copay of record. Then I found out her employer changed the terms of the insurance, so the copay she paid was short by $20. What went wrong?

Answer: You might easily assume that when a patient has the same insurance company, the copay is the same as it has always been. But unless you check first, you won’t know the patient’s coverage has changed until after the fact.

Best practice …

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Is E/M Possible Pre-Colonoscopy?

Posted on 03. Feb, 2010 by .






Question: A local family physician refers a patient to our gastroenterologist for a diagnostic colonoscopy. The patient reports to the practice and meets the gastroenterologist for the first time. After answering some patient questions during a brief introduction, the gastroenterologist performs a diagnostic colonoscopy with brushing. The patient had never met the gastroenterologist before. Is the time he spent with the patient pre-screening a separate E/M?

Answer: Do not report a separate E/M for this encounter. On the claim, report 45378 (Colonoscopy, flexible, proximal to splenic flexure; diagnostic, with or without collection of specimen[s] by brushing or washing, with or without colon decompression [separate procedure]) for the service.

Explanation …

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Oncology Coding 2010 Update: 3 New Lab Services Codes

Posted on 02. Feb, 2010 by .


Watch for your chance to replace 86316 with more specific 86305.

If your oncology practice has its own lab, heads up.

You’re sure to find a few new lab codes “in CPT 2010 that you need to know,” says Peggy Slagle, CPC, billing compliance coordinator at the University of Nebraska Medical Center in Omaha.

Get started with a look at these three codes you’re likely to use in your oncology/hematology practice.

Heed New HE4 Code, 86305 …

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E/M Audits: MAC Sets Up Pre-Pay Edit for Code 99310

Posted on 02. Feb, 2010 by .


87 percent error rate leads to drastic measures.

If you think CMS is only watching your E/M codes when it comes to the office or hospital, think again. One MAC recently reviewed nursing facility care claims and was stunned at the findings.

NGS Medicare, a Part B payer in four states, announced on Jan. 26 that it had recently audited claims for code 99310 (Subsequent nursing facility care, per day), and found that only 13 percent of these claims were billed correctly.

Evaluation & Management Services Performed at Nursing Facilities from Erin masercola on Vimeo.

Based on the outcome of the audit, NGS said that it “will be implementing a prepay edit for CPT code 99310.”

Know these quick facts before you report this nursing facility care code in the future.

1. Check documentation for comprehensive interval history, comprehensive exam, and/or highcomplexity

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What Lab Coders Need to Know About CCI 16.0

Posted on 31. Jan, 2010 by .




Look for transcutaneous hemoglobin limitations, and bundling for those new 2010 culture codes.

Think you’re ready to use all those brand new CPT lab codes? Not so fast. You better learn Correct Coding Initiative (CCI) restrictions first, before you start billing Medicare for services using new CPT 2010 codes.

CCI released version 16.0, effective Jan. 1, which includes 24,060 new active pairs and 869 modifier changes, according to Frank D. Cohen, MPA, MBB, senior analyst with MIT Solutions.

Let our experts walk you through the edits that could make billing for some code pairings difficult for your lab.

Block Out Transcutaneous Hemoglobin

CPT 2010 provides a new code for in situ hemoglobin testing: 88738 (Hemoglobin [Hgb], quantitative, transcutaneous). But according to the latest CCI edits, you can never bill 88738 for a patient on the same day that the lab performs any of the following “mutually exclusive” tests:

• 85013 — Blood count; spun microhematocrit

• 85014 —… hematocrit

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What Medical Coders Should Know About HIPAA Compliance

Posted on 31. Jan, 2010 by .


If you haven’t been paying much attention to HIPAA compliance lately, here are some good reasons to start.

The Health Insurance Portability and Accountability Act (HIPAA) has been around for awhile, but now more than ever, you need to make sure your practice keeps patients’ protected health information (PHI) private and secure.

Eye opener: HITECH, a part of the ARRA stimulus bill passed last year, raises the fines providers must pay if they are responsible for a PHI breach and fail to notify people affected. HITECH also allows state prosecutors to use the federal HIPAA law to prosecute breaches on their own. And the Attorney General in Connecticut is already trying his hand at enforcing HIPAA penalty provisions for security violations.

Supercoder- A Complete Online Medical Guide from Erin masercola on Vimeo.

This past month, 

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