AMPUTATION FOR CIRCULATORY SYSTEM DISORDERS EXCEPT UPPER LIMB AND TOE WITHOUT CC/MCC DRG Code 241

Part B claims with modifier GW are getting Medicare’s Comparative Billing Report treatment. Reminder: Modifier GW indicates the claim is for services not related to the hospice patient’s terminal condition. The CBRs cover paid claims with dates of service from [...]

Billing for services while traveling is a common violation. The hunt for Medicaid home health fraud continues unabated, as evidenced by recent cases. Allied Health Systems in Springfield, Massachusetts, and its CEO Henry Azzun submitted false and/or fraudulent claims to [...]

Avoid using truncated codes. Dragging your feet to incorporate the latest ICD-10-CM codes could lead to denials for services covered by Medicare National Coverage Determinations (NCDs). Change Request (CR) 11491 describes changes to four NCDs that might impact coverage for [...]

See which updates are coming in 2020. Stay informed on recent updates to the to National Coverage Determinations (NCDs). The Centers for Medicare & Medicaid Services (CMS) recently released MLN Matters® 11491 and Change Request (CR) 11491, which includes nine [...]

You’ll see some changes to NCD 20.9.1 “Ventricular Assist Devices.” CMS recently released MLN Matters® 11491 and Change Request (CR) 11491, which made changes to several National Coverage Determination (NCDs). You will see nine changes in all, and five of [...]

Apply these measures to boost your rheumatoid arthritis coding ability. You've got to be particularly careful when coding patients with a rheumatoid arthritis diagnosis. That's because it's one of the most comprehensive portions of the ICD-10 index. And if you're [...]

Take note of the areas HHS will be watching. Are you guilty of one of the top-six HIPAA compliance issues that tend to trigger investigations and enforcement actions by the HHS Office for Civil Rights (OCR)? If so, you’d better [...]

Hint: Don’t confuse fear of flying for claustrophobia. When your psychiatrist diagnoses claustrophobia, you will have to look through the ICD-10 codes for situational phobias to arrive at the correct code for this type of phobia. You should also be [...]

In addition to scores, timing becomes crucial for the right GCS code. In the last issue of the Neurosurgery Coding Alert, you had a chance to review the NIHSS codes. Another similar scale used for neurological assessment is the Glasgow [...]

Warning: HIPAA investigations can drag on for years. Both federal and state authorities are getting serious about HIPAA compliance, and the result is millions paid out in CMPs and settlements. Are you next? Since 2003, the HHS Office for Civil [...]