Medicare Compliance & Reimbursement
Patient's Self-Diagnosis May Not Stick
Question: A 48-year-old female, fearing she has H1N1, reports to the emergency department (ED) complaining of weakness and fatigue; she rates her fatigue at 8 on a scale of 10, saying "I can barely get out of bed." After a level-three E/M that includes a rapid screen, the physician determines the patient does not have H1N1, but is suffering from chronic iron deficiency anemia due to heavy, excessive bleeding associated with uterine fibroids. The patient requests an H1N1 vaccination, which the nurse provides. How should I code this encounter? Answer: You'll report an E/M for the physician's services and the facility will code for the vaccination administration. On the claim, report the following:
Medicare Compliance & Reimbursement
- Payment:
Medicare Puts Details of Annual Wellness Exams in Writing
Medicare creates new denial codes that will apply when you bill AWV incorrectly. CMS has [...] - Trends:
Pumped Up Primary Care May Change Playing Field
There could be more associations between PCPs and specialists, expert predicts. "Primary care is carrying [...] - Diagnosis Coding:
Most Practices 'Surprised' By How All-Encompassing ICD-10 Transition Has Been
Best bet: Establish your initial plan for conversion immediately so you can project your practice's [...] - Tool:
ICD-10 Crosswalks: Never Fear-New Diagnosis Crosswalks Are Here
You'll benefit from the new code set, which includes 2011 diagnoses. In its attempt to [...] - Medicare Billing:
Never Report New Subsequent Observation Codes on the Same Day as Other E/M Code
Plus: CPT clarifies how you should calculate time when using it to pick an E/M [...] - What Do You Think?:
How Would Your Practice Handle This Scenario Involving a Free Med Sample?
Just because you provide a sample as part of care during a visit doesn't mean [...] - Industry News:
MedPAC Calls For 1% Increase to Hospice Payments
Medicare hospice spending has increased 300% over seven years. Hospices would see a 1 percent [...] - Reader Questions:
Patient's Self-Diagnosis May Not Stick
Question: A 48-year-old female, fearing she has H1N1, reports to the emergency department (ED) complaining [...] - Reader Questions:
Make Sure Diagnoses Are in the Right Order
Question: Many of our ophthalmology patients claim general reasons for their visit, such as "I [...]
