Question: Our pediatrician saw a patient that was seen for left leg abscess. The pediatrician had the wound cultured, and the infection came back as methicillin-resistant Staphylococcus aureus (MRSA). My nurse practitioner (NP) coded the claim with A49.02, which was denied [...]
Proposed rule for MPFS 2021 also continues some changes due to COVID-19. August 3 brought the introduction of the Calendar Year (CY) 2021 Medicare Physician Fee Schedule (PFS) proposed rule from CMS – and there were quite a few surprises [...]
Plus: What’s the proposed conversion factor for 2019? The proposed physician fee schedule includes much more information beyond the suggested E/M code changes, including potential updates regarding the quality measures. The proposal suggests adjustments that provide much-needed changes to Measures [...]
Hint: An RN must be in charge of nursing services in your ASC. CMS outlines very specific conditions for coverage (CfCs) for ambulatory surgical centers (ASCs) in 42 CFR, part 416, Subpart C. To make sure you stay compliant with [...]
Ace Your Plan of Correction with 4 Simple Steps If you read about survey strategies in our April newsletter, you’re well prepared for when the surveyor comes knocking. But if not, you may have ended up with some deficiencies. Surveys [...]
Question: One of our surgeons treated a patient with an abscessed wound on his left ankle by debriding the site and ordering a culture to identify any possible infectious organism. The area treated was about 12 sq cm and the debridement [...]
Heads up: Pay attention to the new Excludes1 note. Knowing that a patient has hypertension is an important fact for anesthesia providers to take into consideration as they map out and implement the anesthesia plan. When coding for cardiac cases, [...]
But beware of choosing this code when the diagnosis is NOS. The one-to-one crosswalk from ICD-9 to ICD-10 keeps primary pulmonary hypertension coding fairly simple. You may be surprised by the Excludes1 note with the ICD-10 code, though. ICD-9-CM Code [...]
Check for location and underlying cause for embolism; differentiate arterial and pulmonary embolism. Coding for septic embolism isn’t as confusing as it sounds. You can overcome challenges in embolism reporting if you look for the origin of the embolism. However, [...]
Knowing when to use G codes critical. Billing a pulmonary rehabilitation (PR) program is not really a cakewalk. Take care not to make these common missteps that could derail your PR services’ claims. Pitfall #1: You Think You Know Everything [...]
