Our Flow Chart Does the Incident-To Decision Making for You
Posted on 17. Feb, 2009 by in Toolkit.
Suppose your nonphysician practitioner sees a patient on a day when your physician is working, but is out at lunch. Can you bill the service incident-to? The answer is no.
Use this handy flow chart, created by Barbara Cobuzzi, MBA, CENTC, CPC-H, CPC-P, CPC-I, CHCC, president of CRN Healthcare Solutions, Tinton Falls, N.J. to help you determine when you can bill services incident-to and when you can’t.
Please click here for flow chart.
CD from our live conference: Dr. Tuck’s reimbursement tips for NPPs and other physician extenders.
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Red Tape Robbing Patients of Docs’ Time
Posted on 16. Feb, 2009 by in Provider News.
The Texas Medical Association has now officially proclaimed what you probably already knew: Dealing with health insurance policies and bureaucracies is occupying more of your physicians’ attention, leaving them less time to spend with their patients.
Ninety-three percent of the doctors the TMA surveyed said insurance companies take too much of their time and attention away from patient care, Healthcare Finance News reports. Government payers, such as Medicaid, Medicare, and TRICARE, also rob patients of their doctors’ time, according to 87 percent of physician respondents. Doctors worry that their financial hardships are threatening both quality and access to care for patients … More …
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Got 9? Self-Audit Checklist
Posted on 16. Feb, 2009 by in Toolkit.
If you don’t know quite where to begin when you perform your first self-audit, keep this handy reference as a guide to remind you what types of questions you should be asking yourself. For each chart, make sure you can answer the following 9 questions and you’ll know you’ve done a thorough job:
Retrospective or prospective? E/M audit expert Suzan Berman-Hvizdash helps you decide.
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Coder’s Anatomy: ‘Dorsal’
Posted on 16. Feb, 2009 by in Hot Coding Topics.
Da Dum. Da Dum. DaDumDaDumDaDum. If you can’t always remember all the anatomical terms of location you see in op notes, just think about the movie Jaws for ‘dorsal,’ suggests Joanne Schade-Boyce.
The super-scary fin that comes out of the water is the “dorsal fin” or the fin on the shark’s back. ‘Dorsal’ means “being at the back.”
ASC & surgery coders: Tackle those scary op notes like Captain Quint with more handy tips from Joanne.
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Mind Your Modifiers When Your Surgeon Works With Others
Posted on 16. Feb, 2009 by in Hot Coding Topics.
Automatically appending modifier 52 could be costing you hundreds.
When your surgeon works with another physician during a procedure, you can face major coding challenges. If you don’t coordinate your coding with the other physician’s coder, both doctors could lose money and face audits.
Learn how to correctly code for these shared procedures with this real-world case study.
AUDIO CD: Two-fers! How to get paid for co-surgery and surgical assistance.
Review the Surgical Case
Scenario: A urologist and a general surgeon performed surgery on a patient. The urologist did the orchiopexy and performed the opening and closing. The general surgeon performed an inguinal hernia repair.
Coding dilemma: Which codes should each physician report, and what modifiers should the coders use,
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Coder’s Anatomy: Cardiac Cath & Congenital Abnormalities
Posted on 13. Feb, 2009 by in Hot Coding Topics.
Time Saver: Before you start assigning cardiac catherization codes, make sure you scan a note first for the presence of congenital abnormalities, suggests IVR reimbursement expert Dr. David Zielske.
Why: A congenital abnormality, like a bovine arch, makes a difference in how many ‘turns’ an interventional radiologist makes during a procedure, and therefore affects your choice of non-selective, first order, second order, and third order vascular family codes, Dr. Z explains. If you assume ‘normal’ anatomy, you may have to start over after choosing 10-20 codes. Yikes.
Tip: Train your docs to mention any congenital abnormalities at the beginning of the note.
More cardiac cath reimbursement tips from Dr. Z.
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$12,910 More Per Year For Health Insurance?
Posted on 13. Feb, 2009 by in Provider News.
Imagine a world where insured patients pay DOUBLE the health insurance premiums they pay now. That reality’s just 7 years away, predicts a recent study from the Public Interest Research Group.
Dollar & Cents: That means average yearly premiums will soar from $11,381 to $24,291 by 2016, reports Business Week.
Bright Idea: Cut health care costs by cutting “red tape” at the insurance companies, suggests PIRG co-author Larry C. McNeely II. “Insurers waste billions each year on paperwork that has nothing to do with patient care,” BW relates. “One suggestion is to limit the amount of premium dollars that can be spent on administrative costs … More …
Make sure you get your patients’ money’s worth from those insurers.
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CCI 15.0 Update for Orthopedic Coders
Posted on 13. Feb, 2009 by in Hot Coding Topics.
Consider Nerve Blocks, Injections Inherent to Most New Ortho Codes — Or Face Denials
Correct Coding Initiative (CCI) version 15.0 has lots of edits for orthopedic codes, but our simple 5-step action plan will steer your orthopedic practice clear of Medicare payback requests for fixation, fasciotomy, and aspiration services.
Step 1: Include X-Rays in Multiplane Fixation Codes
First off, your new multiplane external fixation codes (20696, Application of multiplane [pins or wires in more than one plane], unilateral, external fixation with stereotactic computer-assisted adjustment [e.g.,spatial frame], including imaging; initial and subsequent alignment[s], assessment[s], and computation[s] of adjustment schedule[s]); and 20697 (… exchange [i.e., removal and replacement] of strut, each) did not escape CCI 15.0’s notice.
AUDIO ON DEMAND: 2009 Orthopedic Coding Update with Annette Grady.
Codes 20696 and 20697 include dozens of edits, including many x-ray, CT, and MRI codes. Also, these two new codes will now include:
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Pediatric Billers: SCHIP Enrollment Just Got Easier For Your Patients
Posted on 12. Feb, 2009 by in Provider News.
There’s been quite a bit of hoo-ha over the $32.8 billion State Children’s Health Insurance Program bill President Obama signed this week. What got less attention was a memo he sent to HHS lifting certain SCHIP restrictions from the Bush administration, reports The Wall Street Journal.
SCHIP is meant to be a stop-gap for poor children not eligible for Medicaid. Previously, children had to be 250% below the poverty line to qualify for SCHIP. At $50,000 for a family of four, that’s pretty poor in many places, WSJ notes.
Several states had sued the federal government over the Bush restrictions that Obama’s memo makes null and void, the paper adds.
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CCI 15.0 Update for Radiology Coders
Posted on 12. Feb, 2009 by in Hot Coding Topics.
76942 and 78808 on a single claim needs a second look
43,006. That’s the number of additions Correct Coding Initiative (CCI) 15.0 creates. We’ve got what radiology coders need to know, including the 411 on an edit affecting a new nuclear medicine code.
AUDIO Extra: Back-to-Basics Radiology Coding Course.
This round of CCI, effective Jan. 1, attacks the usual suspects — such as including guidance codes 76942 (Ultrasonic guidance for needle placement …) and 77002 (Fluoroscopic guidance for needle placement…) into a code whose descriptor includes imaging guidance: 55706 (Biopsies, prostate, needle, transperineal, stereotactic template guided saturation sampling, including imaging guidance). CCI also had to create new edits to reflect the changes to the hydration/infusion code digits.
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