Despite funding cuts HHS and company remain vigilant in their fight to recover assets. As the stakes continue to rise in healthcare, the opportunity for fraud increases. A recent Office of Inspector General (OIG) publication illustrates that offenders continue to [...]
Question: One of my doctors is a pediatric otolaryngologist, and he sees a lot of patients who were born prematurely. I’m trying to find the best diagnosis code (ICD-9 and ICD-10) to indicate a history of premature birth. The patients he [...]
In Table 3 of the 2014 Home Health PPS Final Rule, the Centers for Medicare & Medicaid Services lists the deleted codes most used in 2012. The top deleted codes used were: 1. 401.0 (Malignant essential hypertension), 34,207 episodes; 2. [...]
Examine your claims to make sure you’re using these codes correctly. In Table 3 of the 2014 Home Health PPS Final Rule, the Centers for Medicare & Medicaid Services lists the deleted codes most used in 2012. The top deleted [...]
Question: Our nurse administered a Synagis injection to a premature baby during a well child visit. Is this bundled into the E/M service or can we report it separately? Answer: In this situation, you’ll report the appropriate preventive medicine code [...]
Make infection control a priority. Starting this summer, expect surveyors to take a closer look than usual at F-441 (infection control) and F-315 (urinary incontinence). That’s because a new report from the U.S. Department of Health and Human Services (HHS) [...]
Don't write off payment for injections, screenings, and other services during preventive exams. When a patient presents to your practice for a preventive medicine visit, you'll simply report a code from the 99381-99397 range and move on, right? Not so [...]
Remember to always document visit times when coding based on the clock.Picture this: A pediatrician provides an E/M service for an established patient that requires an expanded problem-focused history and exam. The E/M encounter, however, takes nearly 45 minutes to [...]
Tip: Skip presenting complaints in outpatient setting if diagnosis is clear.Your CPT codes should always be linked to an appropriate ICD-9 code, but selecting the appropriate ICD-9 code for presenting problems versus underlying conditions can be challenging. Boost your ICD-9 [...]
Question: Our nurse practitioner often administers Synagis injections to premature babies. We're receiving denials stating the diagnosis code is not suitable for thechild's age. The babies are approximately six months old now but were preemies and need the injection. What [...]
