Chiropractic Coding: Avoid This Common Documentation Mistake

Posted on 08. Jun, 2010 by Editor.

Treatment plans are a must, experts say.

You’ve treated your chiropractic patient, you’ve selected the correct codes, and you’ve submitted your claim. All set, right? Not quite. Check out this common mistake that chiropractors make.

“Many chiropractors do not create written chiropractic treatment plans for every new patient,” says Marty Kotlar, DC, CHCC, CBCS, president of Target Coding, a chiropractic coding and billing consulting firm. Use this checklist to ensure you send Medicare the information CMS most wants to see included “with every new patient plan of care,” Kotlar says: (more…)

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Wound Care: Refer to This Handy Chart to Make Graft Coding a Cinch

Posted on 27. May, 2010 by Editor.

Careful: Skip over codes for legs and zero in on foot codes.

With the many graft options — including those taken from cadavers, pigs, and newborns — correctly coding a skin graft procedure can leave you guessing. Use this chart to narrow down the grafting field by matching definitions, product names, and treatment applications to CPT codes. Then, you’ll be sure to sail through coding your next graft claim.

Don’t miss: (more…)

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Recovery Audit Contractors: Know These RAC Fast Facts

Posted on 24. May, 2010 by Editor.

RACs are just another tool in the government’s arsenal to collect improper payments.

You’ve got so many compliance acronyms flying at you every day that you may not be able to differentiate your RAC from the OIG. Know these quick facts about RACs to stay better informed.

• Recovery audit contractors (RACs) detect and correct past improper payments so CMS and the MACs can prevent such problems in the future
• RACs are hired as contractors by the government, and they can can collect “contingency fees,” which means that they get a percentage of the amount that they recover from providers who were paid inappropriately The maximum RAC lookback period is three years, and they cannot review claims paid prior to Oct. 1, 2007 (more…)

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Recognize a Write-Off in 6 Steps

Posted on 09. May, 2010 by Editor.

Save this option for when other collection methods have failed.

You’ve offered discounts, payment plans, and more,but you still haven’t received payment from a patient. You may be forced to do a write-off at this point, says Steve Verno, CMMC, CMMB, NREMT-P, a medical billing consultant and educator in Orlando, Fla. Your practice is justified in writing off a patient’s balance in the following situations:

1. The cost of collecting a balance is more than what the patient owes. For example: A patient’s balance due is $3 after all insurance payments. The administrative cost to bill and collect is at least $15 per statement. “You don’t spend $15 to collect $3,” Verno says. (more…)

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Hodgkin’s Coding: Simplify ABVD Regimen Coding, Easy as 1-2-3

Posted on 09. Apr, 2010 by Editor.

Keep this job aid nearby to keep your Hodgkin’s coding in the clear.

Speed your coding for ABVD chemotherapy coding with this handy summary of the codes most likely to appear on your claim.

But remember: Base your final code choices on the services, drugs, and diagnosis documented. (more…)

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Use This Sample Appeal Letter As Ammo in Your Fight Against Modifier 25 Denials

Posted on 12. Mar, 2010 by Editor.

Attach your procedure notes and the OIG’s report to pack extra punch.

Even if you follow all of CMS’s rules in reporting modifier 25 (Significant, separately identifiable evaluation and management service by the same physician on the same day of the procedure or other service), your Medicare payer may sometimes still choose to deny your claim.

If you feel you deserve the pay for the EM service you performed, you should appeal the denial. Alice Kater, CPC, PCS, coder with Urology Associates of South Bend in Indiana, offers the following sample appeal letter (below) as an example of how she has challenged her payer to collect rightful reimbursement. (more…)

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Optometry Coding: Stop 92081-92083 Denials in Their Tracks

Posted on 19. Feb, 2010 by Editor.

Record visual fields interpretation and report the right way.

Visual fields are a compliance hot spot. Optometrists should use the visual field interpretation and report (I&R) to record what their thinking process was at that moment by recording any changes noticed, how the field compares to other testing like OCT (92135, Scanning computerized ophthalmic diagnostic imaging, posterior segment, [e.g., scanning laser] with interpretation and report, unilateral), their plan for treatment (or not) and when the field needs to be run again. (more…)

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8 Simple Steps Organize Your Op Note Coding

Posted on 12. Feb, 2010 by Editor.

This aspect of op note coding is the “horse that pulls the cart.”

Stuck on how to tackle this op note or those sitting on your desk? Follow this advice, provided by Melanie Witt, RN, CPC, COBGC, MA, an ob-gyn coding expert based in Guadalupita, N.M. and co-presenter of the “Ob-Gyn Op Notes” session at the 2009 Ob-Gyn Coding & Reimbursement Conference in Orlando.

Step 1: Itemize procedures.

Step 2: Assign CPT codes.

Step 3: Eliminate “standard” procedures. (more…)

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Want to Integrate PQRI Measures Into Your Practice? Look Here.

Posted on 28. Jan, 2010 by Editor.

Participation can put extra bread in your basket.

Back again for 2010 is Medicare’s incentive-driven physician quality reporting initiative (PQRI), aimed at tracking quality metric or patient care services that physicians provide. When the practice treats enough patients in the same category, some PQRI dollars might be only a few codes away.

If you know the basics and focus your efforts, PQRI reporting can be a breeze and a boon to your bottom line.

Anyone confused about PQRI — or with questions about setting up a PQRI program in a specialty setting — should go immediately to the CMS PQRI tool kit.

Where? Check out the tool kit here.

“This kit includes valuable resources to assist eligible professionals in the successful integration of PQRI measurement into their practice. CMS suggests that eligible professionals review and discuss the following materials with their staff,” Medicare says.

The kit lists three PQRI “tools” designed to help practices comply with PQRI:

1. 2009 Implementation Advice for 2009 PQRI and E-Prescribing — A publication that introduces the coding and reporting principles underlying successful PQRI reporting.

2. 2009 PQRI Code Master Single Source — A numerical listing of all codes included in PQRI intended for incorporation into billing software.

3. 2009 Data Collection Worksheets — You should use measure-specific worksheets that walk the user step-by-step through reporting for each measure. “These worksheets may be used by the practice on a concurrent basis to collect PQRI data,” CMS says.

Missed the “2010 PQRI: Preparing for Performance” audioconference? Order a CD.

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Checklist: Collect Surgical Deductibles Up Front to Improve A/R

Posted on 17. Jan, 2010 by Editor.

This 3-step checklist will boost your bottom line.

With fewer patients following through on procedures because of economic and financial struggles, and an increasing number of patients not paying their bills, your practice needs to find ways to improve your A/R and bring in deserved money. Adapting an up-front deductible collection policy is one proven way to do both — and setting up a policy can be as easy as 1-2-3.

1. Confirm the Deductible With the Payer

Insurance verification services now make it possible for practices to find out if a patient has met his deductible yet. Some services can tell you how much of the deductible remains unpaid. Because this information is available online, your practice can get this information last-minute, the day of, the day before, or several days before the patient is scheduled to come in for a service or procedure. (more…)

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