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Latest articles

Coding Lesions and Soft Tissue Excisions
April 29th, 2021 - Christine Woolstenhulme, QCC, QMCS, CPC, CMRS
There are several considerations to be aware of before assigning a code for lesions and soft tissue excisions. The code selection will be determined upon the following: Check the pathology reports, if any, to confirm Morphology (whether the neoplasm is benign, in-situ, malignant, or uncertain) Technique Topography (anatomic location) The size Tissue Level Type of closure required Layers ...
58% of Improper Payments due to Medical Necessity for Ventilators
April 29th, 2021 - Christine Woolstenhulme, QCC, QMCS, CPC, CMRS
Proper documentation not only protects the provider, the payer, and the patient, it protects the integrity of the entire healthcare system. When it comes to coverage and documentation for durable medical, the DMEPOS supplier and staff must be familiar with the National and Local Coverage Determinations (NCDs and LCDs) as these are ...
ICD-11 — What’s Happening?
April 20th, 2021 - Wyn Staheli, Director of Research
ICD-11 is officially released, but what does that mean for diagnosis coding in the United States? What's really different? This article discusses what has been happening with ICD-11, some interesting things to note about it, as well as links to other important information.
How to Combat COVID-Related Risk Adjustment Losses with the Medicare Annual Wellness Exam
April 12th, 2021 - Aimee Wilcox, CPMA, CCS-P, CST, MA, MT, Director of Content
Identifying new ways to encourage Medicare beneficiaries to schedule and attend their Annual Wellness Exam (AWE) can be difficult, but the Open Enrollment period is a prime time for every payer to identify new beneficiaries and provide a reminder to both new and existing patients that this preventive service does ...
Failure to Follow Payer’s Clinical Staff Rules Costs Provider $273K
April 12th, 2021 - Wyn Staheli, Director of Research
Clinical staff (e.g., LPN, RN, MA) provide essential services which allow providers to leverage their time and improve reimbursement opportunities and run their practices more efficiently. There is, however, an ongoing question of how to appropriately bill for clinical staff time. This is really a complex question which comes down to code descriptions, federal or state licensure, AND payer policies. Failure to understand licensing and payer policies led a Connecticut provider organization down a path that ended in a $273,000 settlement with both federal and state governments.

Editors choice articles

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
To do a complete exam - you must include the following:
August 26th, 2020 - Christine Woolstenhulme, QCC, QMCS, CPC, CMRS

Latest questions/posts

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

99201, 99211 coding
1st    Jul 8th, 2020 - Coder132 1 

cpt 77002 professional componet with cpt 20610, who charges?
   Jul 2nd, 2020 - sschwartz 4 

ICD 10 code for displacement of cholecystostomy tube
   May 15th, 2020 - Susan

ICD 10 PCS code need for repair of skin of left elbow
1st    May 15th, 2020 - Susan

Cigna R24 Omnibus Reimbursement Policy - EXCEEDS LIMIT
1st    Apr 21st, 2020 - keith

covid 19
   Apr 2nd, 2020 - anitac


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