Back to the Basics: How to Do an Internal Coding Audit

Cathie Wilde, RHIA, CCS - Director, Coding Services Auditing Leave a Comment

Internal coding audits are an important tool in any hospital’s compliance program. They illuminate potential areas for corrections prior to scrutiny by payers and regulators, which can help reduce payer denials and protect revenue. Additionally, performing regular, ongoing internal auditing can improve clinical documentation and coding initiatives, enhance data integrity,...

Coding in the Time of Covid: CMS releases 12 New ICD-10-PCS

C. Matheson, RHIA, CCS Covid-19 Leave a Comment

During this time of year in the coding world we are preparing for the October 1st ICD-10-CM and PCS coding updates, but we were recently surprised with an announcement on July 30th from The Centers for Medicare and Medicaid (CMS). Twelve new ICD-10-PCS procedure codes concerning Covid-19 therapeutics became effective August 1, 2020.  Per the CMS website announcement on...

NEW E/M OFFICE VISIT GUIDELINES PART III

Erika Stevens, CPC - Senior Professional Physician Coding Specialist Best Practices Leave a Comment

E/M office and other and other outpatient visit guidelines will be changing as of January 1, 2021. Below are further details regarding these changes: Read Part I and Part II of this blog for more information. Major E/M revisions for 2021 regarding time of patient encounters include Extensive E/M guidelines additions, revisions, and restructuring Deletion of code 99201...

Preventing Medical Coding Errors

Charlie Saponaro - CEO Medical Coding Leave a Comment

Conducting regular audits of your coding and billing procedures is a great way to identify and eliminate upcoding and incorrect coding incidences within your practice. In a recent article from Becker’s , it is estimated that hospitals overbilled Medicare by $1 billion from inaccurate coding. The office of Health and Human Services (HHS) Office of Inspector General cited...

Don’t Overlook Specialty Areas When Performing Fixed vs Variable Cost Analysis

Charlie Saponaro - CEO Medical Coding Leave a Comment

When you are considering the pros and cons of a variable vs fixed cost structure, don’t overlook certain specialty areas such as registries. For example, On April 2, 2020, the American College of Surgeons (ACoS) sent out a newsletter stating that ACS Accreditation and Verification Programs have been granted an extension of one year for hospitals currently accredited and...

NEW E/M OFFICE VISIT GUIDELINES PART II

Erika Stevens, CPC - Senior Professional Physician Coding Specialist Medical Coding Leave a Comment

With our E/M office or other outpatient visits guidelines changing on January 1, 2021, below are the details explaining the changes. Read part 1 of this article HERE.   Choosing the correct E/M level beginning January 1, 2021 is based on:  The level of medical decision making (MDM) as defined for each service; or  The total time for E/M services performed on the date of...

NEW E/M OFFICE VISIT GUIDELINES PART I

Erika Stevens, CPC - Senior Professional Physician Coding Specialist Medical Coding Leave a Comment

It has been almost 30 years since evaluation and management (E/M) office visit documentation and coding has been changed.  These changes take place beginning January 1st, 2021.  The revised guidelines will improve documentation redundancy and support medical necessity.  In the past, the code selection was based on 3 key elements (history, examination, and medical...

COVID-19 and Its Impact on Cancer Programs

Suzanne Neve, RHIA, CTR - Director, Cancer Registry Medical Coding Leave a Comment

As we continue to feel the impact of COVID-19 in the United States and continue canceling meetings to avoid travel and risks of exposure, many families are also concerned about their loved ones currently going through cancer treatment.  And many others are currently being diagnosed with cancer during this worldwide pandemic.  The big question is how does this impact...

COVID-19 Coding Implications Beyond U07.1

Cathie Wilde, RHIA, CCS - Director, Coding Services Covid-19 Leave a Comment

The current pandemic has prompted the World Health Organization (WHO) to take the unusual step of establishing a unique ICD-10 code for COVID-19 cases, U07.1 five months prior to the traditional U.S. implementation date for new codes. The use of the code became effective with April 1, 2020 discharges and was accompanied by updated coding guidance to the ICD-10-CM Official...

Telemedicine and COVID-19 Follow Up – Where Are We Now?

Erika Stevens, CPC - Senior Professional Physician Coding Specialist Medical Coding 1 Comment

What Does CMS Say?  Congress passed wavier 1135 that states Medicare and other commercial carriers have temporarily expanded services for reimbursement on several telehealth services.  Click here for list of covered services during this Public Health Emergency (PHE) due to COVID-19.  For additional information on COVID-19, click here.  CMS is now releasing News Alerts...

Sign Up For MRA Blog Updates!

Recent Posts