DISORDERS OF THE BILIARY TRACT WITH MCC DRG Code 444

Question: How successful has telehealth use been during and following the COVID-19 pandemic? Pennsylvania Subscriber Answer: Recently, Northwestern University Feinberg School of Medicine researchers examined telehealth use across medical specialties and disparities related to the technology, publishing their results in npj Digital [...]

Don’t mess up this condition of payment. Smart home health agencies will lower their denial rates — and reimbursement losses — by targeting claims’ biggest threat: the face-to-face encounter. New medical review results from HHH Medicare Administrative Contractor Palmetto GBA [...]

About 25 percent of the nation’s agencies will eventually be under RCD. If you’re one of the approximately 1,500 HHAs that will start the Review Choice Demonstration in the next four months, you should learn a lesson from the pioneering [...]

Plus, don’t let Specialty Measure Set limit your physician’s maximum payment adjustment. It’s imperative that coders, physicians, and even practice managers are on the exact same page when it comes to Merit-based Incentive Payment System (MIPS) reporting. That’s because the [...]

If you’re reporting anything other than 58260-58294, prepare for a denial. If your ob-gyns perform hysterectomies for UnitedHealthcare patients, then you need to understand this important coverage determination that will limit your ob-gyn’s approach. Effective April 6, 2015, UnitedHealthcare, UnitedHealthcare [...]

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, [...]

Check where the embolus is located and where it originated. To successfully report embolisms, the embolism origin is the main deciding factor in choosing the primary diagnosis. However, code selection isn’t foolproof. Check out four possible places where you can [...]

Tip: Put etiology at front for confirming diagnosis. To successfully report embolisms, the embolism origin is the main deciding factor in choosing the primary diagnosis. However, code selection isn’t foolproof. Check out four possible places where you can slip and [...]

Additional codes that became invalid for 2012 include: 286.5 (Hemorrhagic disorder due to intrinsic circulating anticoagulants); 425.1 (Hypertrophic obstructive cardiomyopathy); 444.0 (Embolism and thrombosis of abdominal aorta); 516.3 (Idiopathic fibrosing alveolitis); 518.5 (Pulmonary insufficiency following trauma and surgery); 631 (Other [...]

New guidelines warn against coding complications "just because." It's the last hurrah for new ICD-9 codes as the transition to ICD-10 ramps up. Changes for fiscal year 2013 are expected to be minimal (emergency updates only), but changes for 2012 [...]