Revenue Cycle Insider
Compliance:
Pocket This OIG-Centric Compliance Guidance
Published on Thu Oct 24, 2024
You’ve reached your limit of free articles. Already a subscriber? Log in.
Not a subscriber? Subscribe today to continue reading this article. Plus, you’ll get:
Other Articles of
October 2024
- Oncology Coding:
See How These 2025 CPT® Code Changes Will Impact Your Oncology Practice
Get a handle on these sweeping changes before the New Year arrives. Oncology practices across [...] - Gastroenterology Coding:
Correctly Code Blood Clot Removal During an EGD
Question: I have a report that states the gastroenterologist performed an upper gastrointestinal endoscopy (EGD) [...] - Gastroenterology Coding:
Check New Colonoscopy Category III Codes, Updated Telemedicine Options
Plus: CPT® 2025 will roll out a new virtual check-in code. New gastroenterology-related Category I CPT® codes are [...] - Gastroenterology Coding:
Can You Correctly Code This Discontinued Colonoscopy?
Question: A patient came in for a screening colonoscopy. The scope passed per anus, approximately [...] - Pediatric Coding:
Nail Down Strep Pharyngitis Coding
Prepare now for a possible uptick in visits for streptococcal pharyngitis and tonsillitis. In 2023, [...] - General Surgery Coding:
Interpret These Op Notes for ‘Wide Excision’
Question: In the operation report I’m currently coding, the surgeon has characterized the breast procedure as [...] - General Surgery Coding:
Determine the Correct Outcome of This Debridement Procedure
Highlight the differences between the wound and procedure to select the right code. When your [...] - General Surgery Coding:
Attempt This Adjacent Tissue Transfer Case
Question: The surgeon carried out a removal of a basal cell carcinoma, measuring 0.5 x 0.6 [...] - Path/Lab Coding:
Get The Answers to Your Frequently Asked PSA Test Questions
Understand medical necessity to arrive at the correct test code. Your lab probably gets frequent [...] - ICD-10 Coding:
Take Your ICD-10 Coding to the Next Level With These Pointers
Remember the quirkiness of the Index. You probably know that a fear of confined spaces [...] - Oncology Coding:
Assign Signs and Symptoms Dx for This Free Light Chains Test Result
Question: A patient had a lab come back showing elevated light chains. The oncologist indicated [...] - Oncology Coding:
Know Your Options in Pump Disconnect Scenarios
Question: I need some help on the issue of pump disconnects. Specifically, what if you [...] - Otolaryngology Coding:
Get the Answers to All Your External Cause Code Questions
Use them to paint the patient’s complete picture … most of the time. You’re probably [...] - Path/Lab Coding:
Avoid Breast FNA Coding Pitfalls
Question: The pathologist extracted fluid during two fine needle aspiration (FNA) passes from a lesion [...] - ICD-10-CM Coding:
Explore Details for Migraine Dx
Question: I read “migraine” in a patient’s encounter notes, and I’m trying to understand the difference [...] - Ophthalmology Coding:
Ask These 6 Questions, Correctly Determine Diabetic Ophthalmic Complications
Test yourself with these two sticky situations. With almost 250 different diagnosis codes to choose [...] - Pediatric Coding:
Differentiate Between Child and Adult BMI Calculations
Question: Can I use the equation for calculating adult body mass index (BMI) — (weight [...] - Ob-Gyn Coding:
Solve This Separation of Labia Scenario
Question: I’m looking for some assistance on the below procedure note. I’m leaning toward an office [...] - General Coding:
Find Answers to 8 Basic NCCI Questions
Test yourself: Do you know which category of services aren’t covered by NCCI? 1. Question: What [...] - Otolaryngology Coding:
Understand Repair or Correction for Correct Septoplasty Coding
Question: A patient had surgery on a septal deviation with a perforation of 1 cm. [...] - Path/Lab Coding:
Focus Panel Test Coding for UTI Scenario
Question: During a second course of antibiotics for a urinary tract infection (UTI), the clinician [...] - Otolaryngology Coding:
Don’t Deny This NCCI Bundle
Question: Is it possible to get paid for 92504 and 69210 when the two services are [...] - E/M Coding:
Follow This Guidance for Flawless E/M Coding (Part 1)
Don’t get caught out watching the clock. You may think you have a handle on [...] - Ob-Gyn Coding:
Learn What to Do When Induction Takes Days
Question: Do most insurances cover evaluation and management (E/M) codes for patients who are scheduled for [...] - Ob-Gyn Coding:
Here’s What to Ask Your Payers About IUD Coding
Understand why some payers won’t pay for removals. Many coders confess they’re tearing their hair [...] - Medicare Regulations:
Remember SDOH Assessment Responsibilities
Question: When exactly do we need to perform and report social determinants of health (SDOH) [...] - E/M Coding:
Don’t Round Up Encounter Time
Question: One of my colleagues has a habit of rounding up the time our provider [...] - Pediatric Coding:
To Bill E/M, Exam Must Go Above and Beyond
Question: I work at a pediatrician’s office and had an encounter where a patient came [...] - Primary Care Coding:
Take This Advice, Keep Your 2024-25 Winter Vaccine Coding Healthy
Keep your respiratory virus vaccine administration reporting on point. Each year, respiratory viruses are responsible [...] - Pain Management Coding:
Know Synonyms for Shingles to Improve Dx Selection
Question: Encounter notes indicate a patient suffered from “herpes zoster myelitis,” but I know that the [...] - Podiatry Coding:
Master Routine Foot Care Coding
Patient and practitioner education are key to successful claim payment. When it comes to foot [...] - General Coding:
Count Caregiver Counseling As Distinct Time
Question: Can I report a physician’s discussion with an elderly patient’s caregiver about the correct [...] - Compliance:
Understand ‘CIA’ As it Pertains to Healthcare
Question: I’m new to the front desk of a medical practice and heard a colleague [...] - Podiatry Coding:
Code These Diabetic Ulcers and Complications in the Correct Order
Question: My podiatrist is treating a patient with diabetes who is also suffering from peripheral angiopathy. [...] - Primary Care Coding:
Consider Patient Exigencies in Light of No-Shows
Question: Are there any specific guidelines for billing no-show appointments for Medicaid patients? New York Subscriber [...] - Cardiology Coding:
Conquer Electrophysiologic Evaluation Conundrum With Ease
Question: My provider tested the electrical activity of a single-chamber cardioverter defibrillator device’s leads and its [...] - Pain Management Coding:
Only Report Add-Ons for Guidance When Appropriate
Question: A patient with alcohol-related chronic pancreatic cirrhosis reports to the pain management (PM) specialist for [...] - Compliance:
Know What Counts as PHI
Question: I want to be able to explain protected health information (PHI) to onboarding colleagues. [...] - Ophthalmology Coding:
Beware Coding for Blepharoptosis Repair
Question: Our ophthalmologist performed a technique to repair blepharoptosis by suspending the eyelid from the [...] - General Coding:
Know Limitations of Coder Privileges
Question: One of the patient records I’m reviewing shows a pretty big discrepancy between the [...] - Primary Care Coding:
Try These Tips for Smoking Cessation Without Tobacco-Related Disease Symptoms
Question: Smoking and tobacco use cessation counseling services require an appropriate diagnosis code, but what if [...] - Ophthalmology Coding:
Know When, and When not, to Bundle Goniotomy, Cataract Removal
Question: When our ophthalmic surgeon performs goniotomy in connection with the insertion of an aqueous drainage [...] - Practice Management:
Read the Fine Print on Payer Policies for Medical Necessity
Question: Isn’t preventive care implicitly medically necessary? Massachusetts Subscriber Answer: Most payers probably aren’t interested [...] - Practice Management:
Remember Copays are Contractual
Question: Can front desk staff waive copays at their discretion? For example, if a patient [...] - Pain Management Coding:
New Block Code Set for CPT® 2025
Thoracic block? There’s a code for that next year. CPT® has released its list of [...] - ICD-10-CM Coding:
Know There’s No Specific ICD-10-CM Option for Documenting ‘Gummies’
Question: Which code would I use for documenting the accidental ingestion of a cannabis gummy? Oregon [...] - Diagnostic Radiology Coding:
Avoid Coding Unnecessary Spine Regions
Question: I have a radiology report following a computed tomography (CT) scan with contrast that lists [...] - Neurosurgery Coding:
Assessing Patient for TBI
Question: Encounter notes indicate that the neurosurgeon treated a new patient who had just suffered a [...] - Cardiology Coding:
Rely on This Code for Sinus Bradycardia
Question: Which ICD-10-CM code should I report for sinus bradycardia? Louisiana Subscriber Answer: Report R00.1 (Bradycardia, [...] - Podiatry Coding:
Distinguish the Differences Between Walking Boot HCPCS Codes
Question: I’m curious about the distinction between codes L4360 and L4361. My vendor mentioned that L4360 [...] - Medicare Regulations:
Pay Attention to Medicare POS Intricacies
Question: My provider sees Medicare beneficiaries in other facilities outside our office. I’m trying to nail [...] - Cardiology Coding:
Elevate Your CPT® 2025 Expertise With These Quick Questions
Remember: You won’t be able to report 99441 next year. With January 1 comes a [...] - Diagnostic Radiology Coding:
Determine the Correct Dx Codes for AV Hemodialysis Access
Question: I have a coding question on bilateral upper extremity vein mapping. My facility is struggling [...] - Anesthesia Coding:
Take These Steps for Accurate Anesthesia Service Formulation (Part 1)
Billing for base units is just the beginning. Are you new to anesthesia coding? Or [...] - Emergency Department Coding:
Check 5th Character Requirements on Liver Disease Dx
Question: When a patient suffers from alcoholic liver disease, what is the best way to choose [...] - Neurosurgery Coding:
Get Your Claim to Flower With POTS Dx
Question: Encounter notes indicate that a patient suffers from “POTS.” I’m not really sure what this [...] - Urology:
Look For New CPT® Codes in 2025
Question: Could you please inform me of any upcoming changes or updates to the CPT® [...] - Compliance:
Pocket This OIG-Centric Compliance Guidance
Build a solid compliance foundation so you’re not caught unawares. People who have spent years [...] - Emergency Department:
Repeat Rabies Vax Presents E/M Coding Challenges
Question: Our office is currently engaged in a debate regarding the appropriate coding for a patient [...] - Medicare Regulations:
Pocket These Tips for Documenting Mental Health Services for Medicare Beneficiaries
Explore how Medicare is expanding and reimbursing behavioral health services. On January 1, 2024, Medicare [...] - Urology:
Brush Up on Your Coding of This Bladder Instillation
Question: My urologist successfully inserted a 16-French foley catheter into the patient’s bladder without encountering any [...] - Anesthesia:
Code Minus Modifier in this Discontinued Surgery Scenario
Question: We are billing for a certified registered nurse anesthetist (CRNA) provider contracted with a local [...] - Neurosurgery Coding:
CPT® 2025 Puts New Ablation, Thoracic Block Codes on Tap
Code represents MRI/US combo. CPT® has released its list of new, revised, and deleted codes [...] - Diagnostic Radiology Coding:
Get Answers to Your CT Scan Coding FAQs
Find out which CT scans require 3D rendering. Whether you’re newly credentialed or have been [...] - Emergency Department:
Consider Complexities of Encounter on Nosebleed, Earwax Encounters
Remember the rules for procedure coding on these common services. Sometimes, how you code a [...] - Urology:
Employ Tried-and-True Methods to Convert This Endoscopy Report Into Coder-Speak
Trust your knowledge of anatomy so nothing gets lost in translation. Interpreting and accurately translating [...] - Anesthesia:
Crosswalk This Spinal Code for C-section Scenarios
Question: A patient came in for a scheduled cesarean section and was given a spinal. Should [...] - Evaluation and Management:
Document These Aspects of Drug Management for E/M Service
Question: When is an evaluation and management service of medication justified? RCI Subscriber Answer: “Management” [...] - Orthopedic Coding:
Know Wrist Pain, CTS Dx Differences
Question: What is the difference between carpal tunnel syndrome (CTS) and wrist pain? Also, how should [...] - Orthopedic Coding:
Radial and Ulnar Fracture Fix
Question: The orthopedic surgeon treats a patient with a right-sided radial and ulnar fracture with angulation. [...] - Pulmonology Coding:
Prepare for the New Year’s Telemedicine Coding Options
Brief check-ins also receive a code. While the Pulmonary section of the CPT® code set [...] - Practice Management:
Maintain or Even Boost Practice Margins With These Tips
Rely on evaluations and engagement to bolster your healthcare business. “One of the things impacting [...] - Orthopedic Coding:
Look to New Plane Block Code for 2025
Technique could improve post-op outcomes. CPT® has released its list of new, revised, and deleted [...] - Pulmonology Coding:
Ask These Questions When Searching for an AI Coding System – Part 2
Will the price point deter future adopters? In the first part of this article, Pulmonology [...] - Pulmonology Coding:
Seek Out The Correct Asthma Diagnosis Code
Question: A patient presented with an acute asthma exacerbation and the pulmonologist administered a nebulizer treatment [...] - Pulmonology Coding:
Documentation is Key to Reporting Modifier 22
Question: When is it correct to append modifier 22 to procedures or services? Wisconsin Subscriber Answer: Modifier [...] - Technology & Innovation:
How Can AI Affect Your Practice? Get Answers to Your AI-Coding FAQs
Find out if auditing could be a new career option. Artificial intelligence (AI), natural language [...] - Technology & Innovation:
CMS Notifies Beneficiaries of a Security Vulnerability
Question: Why does it seem that only private payers are victims of data breaches? Do government [...] - Technology & Innovation:
Deliver Insulin for 3 Days With a Wearable Patch
Question: We see several patients with type 2 diabetes who require regular insulin injections. Many of [...]
View All
