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Latest articles

CMS says Codes are on the Move!
December 9th, 2019 - Chris Woolstenhulme, QCC, CMCS, CPC, CMRS
Have you noticed your LCDs are missing something? CMS is moving codes out of LCDs and into Billing and Coding Articles. MACs began moving ICD-10-CM, CPT/HCPCS, Bill Type, and Revenue codes in January 2019, and will continue through January 2020. Therefore, if there is an LCD with its codes removed, you will find ...
Preview the PDGM Calculator for Home Health Today
December 4th, 2019 - Wyn Staheli, Director of Research
Until February 1, 2020, you can preview Find-A-Code's Patient-Driven Groupings Model (PDGM) home health payment calculator by going to https://www.findacode.com/tools/home-health/ .
Hypertension ICD-10-CM Code Reporting Table
November 25th, 2019 - Wyn Staheli, Director of Research
In ICD-10-CM, hypertension code options do not distinguish between malignant and benign or between controlled and uncontrolled. What is important for code selection is knowing if the hypertension is caused by or related to another condition. The following table shows some of these options.
New Medicare Home Health Care Payment Grouper — Are You Ready?
November 25th, 2019 - Wyn Staheli, Director of Research
In 2020, Medicare will begin using a new Patient-Driven Groupings Model (PDGM) for calculating Medicare payment for home health care services. This is probably the biggest change to affect home health care since 2000.
VA: How UCR Charges are Determined
November 20th, 2019 - Chris Woolstenhulme, QCC, CMCS, CPC, CMRS
How does the VA determine charges billed to third party payers for Veterans with private health insurance? According to the VA. "38 C.F.R 17.101 stipulates the basic methodology by which VA bills third party insurance carriers. In order to generate a charge for medical services, VA establishes reasonable charges for five ...

Editors choice articles

VA: How UCR Charges are Determined
November 20th, 2019 - Chris Woolstenhulme, QCC, CMCS, CPC, CMRS
How does the VA determine charges billed to third party payers for Veterans with private health insurance? According to the VA. "38 C.F.R 17.101 stipulates the basic methodology by which VA bills third party insurance carriers. In order to generate a charge for medical services, VA establishes reasonable charges for five ...
Q/A: Q/A: How do I Code a Procedure for the Primary Insurance so the Secondary Can Get Billed?
November 19th, 2019 - Wyn Staheli, Director of Research
Question: How do you modify a code submitted to the primary insurance company to let them know it is not covered by them so you can bill to a secondary?
Documentation Tips
November 18th, 2019 - Christine Taxin
Documenting Medical NecessityTo receive reimbursement from medical insurers, you need to make a case that proves that dental surgery is necessary for the patient. To make your case, you need to explain your decision process in terms that a medical insurer can understand, using ICD-10 codes and CPT codes. These ...
HIPAA Final Rule Eliminates HPID and OEID
November 12th, 2019 - Wyn Staheli, Director of Research
Final rule eliminates the requirement for health plans to obtain a unique health plan identifier (HPID) and also eliminates the voluntary use of the other entity identifier (OEID). This change becomes effective December 27, 2019.
And Then There Were Fees...
November 11th, 2019 - Chris Woolstenhulme, QCC, CMCS, CPC, CMRS
Find-A-Code offers fees and pricing for just about everything, this article will address two of some of the most common payment systems with CMS. (OPPS) -Outpatient Medicare Outpatient Prospective Payment System. (MPFS)- Medicare Physician Fee Schedule The Fees section on each code page is determined on the type of services...

Latest questions/posts

CPT code for Interosseous Bioplasty
   Dec 12th, 2019 - rdinaso    12  1 

medicaid primary claim denied due to timely fling
   Dec 12th, 2019 - NAHAR, SHAMSU

codes 27310
1st    Dec 10th, 2019 - maryN.

Gastroenterology question on codes
   Dec 9th, 2019 - trixiecane

Gastroenterology question on codes
1st    Dec 9th, 2019 - trixiecane

J1071 Code
1st    Nov 15th, 2019 - Alicia

Code for Escharotic treatment?
1st    Nov 12th, 2019 - Amanda_Marie

CPT 96405
   Nov 12th, 2019 - npott1 9 

Extirpation of matter from the Pulmonary Artery
   Nov 1st, 2019 - stomach1 3 

Blue cross Blue shield denies office visits/E& M visits.
   Oct 15th, 2019 - gowri.tina

Consultations
1st    Oct 15th, 2019 - MaureenK

HCPCS Code for a Strassburg Sock
   Oct 10th, 2019 - lhaas01 13 

CPT 82948
1st    Sep 18th, 2019 - NAHAR, SHAMSU

hospital codes
   Sep 17th, 2019 - nate0922 7 

CPT code 97760
   Sep 17th, 2019 - RedKat  

Both COPD and Bronchiectasis?
1st    Sep 16th, 2019 - JackKline

CPT 93925
   Aug 20th, 2019 - stomach1 3 

Code for physical activity counseling
1st    Aug 9th, 2019 - Corley

CPT 29799
   Jul 30th, 2019 - RedKat  

Physician ESRD Capitation Billing
   Jul 11th, 2019 - anitac


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