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Latest articles

Chronic Pain Coding Today & in the Future
July 19th, 2021 - Wyn Staheli, Director of Research
Properly documenting and coding chronic pain can be challenging. As is commonly the case with many conditions, over the years, there has been a shift in the identification of different types of pain, including chronic pain. Understanding where we are now and where we are going will help your organization prepare for the future by changing documentation patterns now.
How Does Global and Professional Direct Contracting (GPDC) Affect Risk Adjustment?
July 15th, 2021 - Aimee Wilcox, CPMA, CCS-P, CST, MA, MT, Director of Content
CMS recently announced the 53 Direct Contracting Entities (DCEs) that will be participating in the April 1, 2021 through December 31, 2021 Global and Professional Direct Contracting (GPDC) Model. Among those participating is Clover Health Partners, who runs an in-home primary care program that has the potential to help Medicare ...
How to Properly Assign ICD-10-CM Codes for Pain
July 14th, 2021 - Aimee Wilcox, CPMA, CCS-P, CST, MA, MT, Director of Content
Pain is a common diagnosis among all specialties so it should not be surprising to find there are 162 ICD-10-CM codes for reporting it and over 80 mentions in the ICD-10-CM Official Guidelines for Coding and Reporting which describe when certain types of pain should be reported and how the codes should be sequenced.
Will CMS Allow Medicare Advantage Organizations to Risk Adjust from Audio-Only Encounters? 
July 13th, 2021 - Aimee Wilcox, CPMA, CCS-P, CST, MA, MT, Director of Content
While audio-only telehealth services became a covered benefit during the PHE, CMS put limitations on using the data from those encounters for risk adjustment scoring. Medicare Advantage (MA) plans cannot use the information from these encounters to be scored for risk adjustment; however, it can be used for risk adjustment scoring of ACA plans.
Compliance in the Dental Office or Small Practice
June 29th, 2021 - Christine Woolstenhulme, QCC, QMCS, CPC, CMRS
If your practice does not already have a compliance program in place, you will want to get started after reading this article. We have uncovered some important findings with the Office of Inspector General (OIG) in dental practices you need to be aware of. A compliance program offers standard procedures to follow, ...

Editors choice articles

PCS Coding for Ankle Fracture - Look Deeper Into the Codes!
May 25th, 2021 - Christine Woolstenhulme, QCC, QMCS, CPC, CMRS
Coding Lesions and Soft Tissue Excisions
April 29th, 2021 - Christine Woolstenhulme, QCC, QMCS, CPC, CMRS
COVID-19 Vaccines
March 10th, 2021 - Christine Woolstenhulme, QCC, QMCS, CPC, CMRS
Not Following the Rules Costs Chiropractor $5 Million
September 1st, 2020 - Wyn Staheli, Director of Research
Is COVID-19 Causing Risk Adjustment “Gotcha’s”?
August 27th, 2020 - Wyn Staheli, Director of Research

Latest questions/posts

Medicare Part A billing for CPT 27447
1st    Jul 1st, 2021 - Boss Lady

Chiropractic Billing
1st    Jul 1st, 2021 - GCGchiro

integmentary biopsy
1st    Jun 18th, 2021 - Sunny_day3

ER/Hospitalist Professional Visits
1st    Jun 4th, 2021 - Dawna 1 

GA GY necessary on therapies not covered by Medicare?
1st    May 25th, 2021 - TammyC

97140 or 97124 and What Modifier?
1st    May 19th, 2021 - Anj 1 

Hello Everyone
1st    Apr 9th, 2021 - evopryseo 3 

chiropractic body region question
1st    Mar 15th, 2021 - GregoryH

biopsy of a perianal lesion/malignancy.
1st    Mar 10th, 2021 - btalley

Cardiothoracic Coders
   Feb 8th, 2021 - rdinaso    12  1 

water massage table
1st    Jan 27th, 2021 - KayC

Code G8730 rejection
1st    Jan 20th, 2021 - LEEs

Combination Codes
1st    Jan 7th, 2021 - BeckyR

Insurance Rejections For Medical Necessity - Can 2nd insurance be billed?
   Dec 29th, 2020 - sharris

If you know a procedure will be denied as cosmetic can an E/M be charged instead?
   Dec 1st, 2020 - sschwartz 4 

Elongated Toenails
   Nov 23rd, 2020 - sharris

Does National CPT Tracking exist?
1st    Nov 12th, 2020 - ShawnV

Bought out an Existing Practice
1st    Nov 5th, 2020 - SBerg

Nail Debridement vs Nail Trimming
   Nov 5th, 2020 - sharris

AT modifier use for spinal manipulation services
   Nov 2nd, 2020 - JBrooks 1 

GA modifier
1st    Sep 30th, 2020 - ACC

97110, 97530, 97012
1st    Sep 24th, 2020 - ChiroCasey

Manipulation Therapy & Habilitative/Rehabilitative Services
1st    Sep 22nd, 2020 - Coding&Thriving

99204
1st    Sep 18th, 2020 - smattiko

G-Codes
1st    Sep 8th, 2020 - MKramer

posterlateral fusion with inpatient stay
1st    Sep 4th, 2020 - Rambis

G0481
   Sep 3rd, 2020 - EXECD

Two modifiers
1st    Aug 21st, 2020 - sunshine1991

peer to peer
   Aug 13th, 2020 - trixiecane   

Open Thoracotomy
   Jul 13th, 2020 - rhblevins


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