When Patient Payment Plans Pay Off Better Than Collection Agencies

Posted on 06. Jul, 2009 by in Hot Coding Topics.


Recession Relief: Ready to call a collector? Here’s a cheaper, alternate plan that can save patient relations & bring in more cash.

If you’re like many medical practices, you’re struggling with how to collect from patients who are struggling financially. But before you shell out money for a collector, consider the advantages of patient payment plans.

Wayne Miller reveals more ways to recession-proof your practice. Learn about the stimulus law, mortgage terms, capital avenues and more.

Although it may take longer to get your money, a payment plan will help financially struggling patients avoid an outside collector, says Catherine Brink, CMM, CPC, CMSCS, president of Healthcare Resource Management in Spring Lake, N.J.

With payment plans, “you have some income coming in versus sending [patients] to collections and possibly never getting paid,” agrees Michelle Radmer, billing specialist for Greater Milwaukee Otolaryngology in Greenfield, Wis. Offering payment plans

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PFS 2010 Highlights: Consultations Axed, More Reimbursement for PCPs

Posted on 05. Jul, 2009 by in Provider News.


Right before many of us left for the beach or other July 4th hijinks, CMS released the proposed Medicare Physician Fee Schedule for 2010. That’s right. The fun’s over. It’s time to take off your flip flops, and take in some big proposed changes to Medicare reimbursement for physicians:

No more coverage for consultations: Many coding and reimbursement experts have seen this one coming. CMS wants to eliminate Medicare coverage for consultations, “which are typically billed by specialists and are paid at a higher rate than equivalent evaluation and management (E/M) services,” the agency notes in a press release. Instead, physicians will bill for E/M services, and the savings from axing consultations will go toward raising E/M reimbursement, CMS says.

Good news for PCPs: CMS wants to raise reimbursement for primary care providers, including family doctors, internists, and geriatric medicine…

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Endoscopy Documentation Checklist for Physicians

Posted on 05. Jul, 2009 by in Toolkit.


Do you feel like you never have enough information in your gastroenterologists’ endoscopy reports to code correctly? Here’s help. Give them this handy little documentation checklist that they can refer to when they dictate endoscopy procedures:

If the patient had multiple polyps or lesions, describe location and treatment method for each one. “Multiple polypectomies” does not give your coder enough information.

Provide both pre-op and post-op diagnoses. If there were no findings, use the pre-op diagnosis twice.

Document a specific anemia diagnosis, if appropriate. Most Medicare payers won’t accept 285.9 (Anemia, unspecified) to support colonoscopy or EGD.

If the patient had a screening colonoscopy due to family history of colorectal cancer, document which family member or members. Must be sibling, parent, or child to qualify.

If you used a templated electronic health record, make sure descriptions actually match what was performed. If there were differences, add notes of explanation to prevent…

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CPT 88112 Challenge: Can You Charge for Slide Prep?

Posted on 04. Jul, 2009 by in Hot Coding Topics.


Question: Our cytology lab prepares slides for UroVysion FISH by liquid based preparation (thin-prep). Can we charge 88112?

Answer: Labs may perform Abbott Laboratories’ Uro-Vysion FISH test for bladder cancer using fresh urine specimens or liquid-based cytology slides. If your lab makes a thin-layer preparation slide from a urine specimen for fluorescence in situ hybridization (FISH), you can list the slide prep as 88112 (Cytopathology, selective cellular enhancement technique with interpretation [e.g., liquid based slide preparation method], except cervical or vaginal). If the pathologist does not interpret the thin-prep slide because you’re only using it for UroVysion testing, you should append modifier TC (Technical component) to 88112.

The commercial UroVysion FISH kit for bladder cancer detection uses fourcolor interphase DNA probes, so the proper coding for the test is four units of 88368 (Morphometric analysis, in situ hybridization [quantitative or semiquantitative], each probe; manual).

AUDIO: Peggy Slagle,…

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Is Your Practice Making This Revenue-Busting Mistake?

Posted on 03. Jul, 2009 by in Provider News.


File this statistic in ‘boneheaded financial moves.’

One third of physician practices don’t accept credit cards, and that number is up 5% from last year, reports American Medical News.

The plastic boycott is puzzling. More patients are paying for health care out-of-pocket, and a credit card payment means money in the bank for a practice rather than having to fuss with collections efforts later on, practice management experts point out.

What doctors can’t stomach: The credit card processing fees, which amount to 3-4% of the transaction … More from American Medical News.

Be a hero. Learn ways to recession-proof your practice. An audio training event with Wayne Miller.

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Orthopedic Coder’s ICD-9 Update: New Radius, Ulna Torus Fracture Codes

Posted on 03. Jul, 2009 by in Hot Coding Topics.


Come Oct. 1, you’ll no longer will you look to 832.0 for nursemaid’s elbow.

Does your orthopedist treat children’s arm problems with regularity? If so, then you may have three new ICD-9 codes to use as of Oct. 1. Take advantage of this sneak peak at the proposed orthopedic additions, and you’ll be ahead of your peers.

NEW: COSC™ Training Camps. Top-notch instructors prepare you to take the AAPC’s specialty certification for orthopedic coders. Coming soon to a city near you.

Most of the new codes will offer additional specificity to existing diseases, which can help you code more accurately. Orthopedic coders, however, had hoped for a wider range of codes, says Leslie A. Follebout, CPC, COSC, PCS, coding manager at Peninsula Orthopaedic Associates in Salisbury, Md.

For instance, you may not celebrate the addition of fifth digits to existing codes 274.0 (Gouty arthropathy) and 453.8 (Other venous embolism and thrombosis of other specified veins). You may, however, find some brand-new additions.

Here’s 3

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CPT 45380 Challenge: Endoscopy with Biopsy

Posted on 01. Jul, 2009 by in Coding Challenge, Hot Coding Topics.


Question: My gastroenterologist performs mapping biopsies on patients who have inflammatory bowel disease. In this procedure, the doctor performs an endoscopy and takes a biopsy every 20 centimeters or so. How should I code this?

Answer: No matter how many biopsies your physician takes, code 45380 (Colonoscopy, flexible, proximal to splenic flexure; with biopsy, single or multiple) once.

If the procedure is unusually extensive or time consuming, you could append modifier 22 (Increased procedural services). You would have to provide the payer with a well-documented and convincing argument — comparison of time with a normal biopsy procedure, number of biopsies and sites, substantial complications —  as to why it should give your office additional reimbursement. Even then, you shouldn’t hold your breath in anticipation of extra money.

ON DEMAND: Stellar strategies for coding upper GI endoscopic procedures, from Jan Rasmussen.

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CCI 15.2 Retracts Neurostimulator Edits from 15.1

Posted on 01. Jul, 2009 by in Provider News.


Look for new edits that affect eye exam codes, anesthesia, and vent management.

The Correct Coding Initiative (CCI) may have startled coders with what looked like a twisted April Fool’s prank: the April 1 edit bundling applied neurostimulator code 64550 into hundreds of other procedures. But new version 15.2 corrects that error, deleting these bundles retroactive to April 1, 2009.

The new version of CCI, which takes effect on July 1, does bundle 64550 (Application of surface [transcutaneous] neurostimulator) into several anesthesia codes (such as 01920 and 01922), “but this is nothing considering that code was bundled into practically every other code in CPT prior to the new CCI deletions,” says Atlanta-based coding consultant Jay Neal.

Use the appeals process like a pro. An audio training event with Barbara Cobuzzi.

Anesthesia affected: Of the 3,565 new edit pairs, a full 65 percent of the column 1 codes are in the…

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Op Note Coding Clinic: Breast Reconstruction with AlloDerm

Posted on 01. Jul, 2009 by in Hot Coding Topics.


Surgeons now commonly use AlloDerm in a variety of surgeries, including breast reconstruction procedures. This product and the work associated with using it can present some unique coding challenges, and there are some big coding changes that take effect July 1.

Let our experts help you sort through some of the breast reconstruction surgery coding myths you might encounter. Uncover the truth about AlloDerm coding using this case study presented by Dolores D. Carey, CCS-P, physician-based coder for Loyola University Physician Foundation in Maywood, Ill.

HAVE YOU BEEN USING THE WRONG MODIFIER? It’s not too late. Becky Zellmer’s audio shows you how to recoup the money you’ve lost.

Operative note: The surgeon performed a bilateral mastectomy. He created a submuscular pocket on the patient’s left side after achieving meticulous hemostasis and removing the pec inferiorly. He placed an implant — medium-height Contour Profile Mentor 275cc — into the pocket after achieving

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E/M Coding Toolkit: Outpatient-to-Inpatient Encounters

Posted on 29. Jun, 2009 by in Toolkit.


If you’re not sure what to report for hospital admissions from office visits, you can simplify your options with this E/M combination service coding chart.

NEW! CEMC™ Training Camps. Coming soon to a city near you.

Scenario Report Codes
FP admits patient to the hospital from the office and doesn’t see the patient in the hospital on the same date Office visit 99201-99215
FP admits patient to the hospital from the office and sees the patient in the hospital on the same date Initial hospital care 99221-99223
FP admits patient to the hospital from the office and sees the patient in the hospital on the following date Office visit + Initial hospital care 99201-99215; 99221-99223
FP A admits patient to the

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