OTHER CIRCULATORY SYSTEM DIAGNOSES WITH MCC DRG Code 314

Medical terminology will help you code these conditions more easily. Your podiatrist is likely to see patients with a variety of foot and ankle ulcers. In Podiatry Coding Alert Volume 15, Number 4, we looked at code choices for pressure [...]

HHAs are losing 2.5% of payments per year. It’s not only the behavioral adjustment cut related to low utilization payment adjustments that’s the problem in the 2021 proposed rule for home health payment. PDGM’s whole LUPA methodology needs a rethink, [...]

PDGM to create winners and losers. A payment rate increase that would usually draw praise is getting largely ignored as home health agencies try to figure out what their finances will look like in 2020 under the Patient-Driven Groupings Model. [...]

Agencies look to hospital P&E program for clues. Home health agencies now know more about what they’ll be facing under the “Probe & Educate” medical review initiative focused on face-to-face physician encounter compliance, thanks to a Nov. 9 MLN Matters [...]

Coding a patient’s visit can be difficult when the beneficiary can’t share his history (See page 314), but even when he can, you’re still faced with other documentation issues that can trip you up. For many providers, problems can arise [...]

Question: Our new patient was referred to home health with a new diagnosis of congestive heart failure (CHF). He also has a cystostomy infected with gram negative bacteria, cellulitis of the groin, uncontrolled type 2 diabetes, and diabetic polyneuropathy. How should [...]

E/M codes will likely be more appropriate for your pediatrician’s services. Your pediatricians probably see patients for medication monitoring at least a few times a week—but if you’re not coding these correctly, you could be risking thousands of dollars a [...]

If you perform these services, go beyond the E/M codes to boost your revenue. Although the E/M codes are the bread and butter for pediatric practices, that doesn’t mean your procedures should always be rolled into your E/M services. In [...]

Question: If our pediatrician performed an electrocardiogram (ECG) (93000-93010, Electrocardiogram, routine ECG with at least 12 leads ...) to monitor medication such as Ritalin, should I use late effect of medication code 909.5? Answer: No, you should instead use V58.69 (Long-term [current] [...]

CMS doesn’t budge from 5-8% figure in final rule. Home health agencies and their representatives had plenty to say about a value-based purchasing program slated for 2016, but will CMS listen? Reminder: This summer, the Centers for Medicare & Medicaid [...]