Posted and filed under Coding.

Enlight-10-ment: November

Reasons (other than disease) for Services Chapter 18 Symptoms, Signs and Abnormal Clinical and Laboratory Findings, Not Elsewhere Classified (R00-R99) Patients often present with signs or symptoms that may point to several “working” diagnoses. These conditions are the reasons patients present for evaluation, testing and sometimes treatment without definitive diagnosis assignment or where one is…

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Posted and filed under YouBeTheCoder.

You Be The Coder: October

Can you identify what these medical abbreviations stand for? DOE ICP LBW NST PUD PWB AFB LUE NVD PAT Answers:  Dypsnea on Exertion Intra Cranial Pressure Low Birth Weight Non Stress Test Peptic Ulcer Disease Partial Weight Bearing Acid Fast Bacilli Left Upper Extremity Nausea, Vomiting, Diarrhea Paroxysmal Atrial Tachycardia

Posted and filed under Coding, Healthcare.

Importance and Usage of Modifier 25

Modifier 25 Appropriate Use Modifier 25 indicates a “significant, separately identifiable evaluation & management (E&M) service by the same physician on the same day of the procedure or other therapeutic service.” Both services rendered must be significant, separate and distinct Medicare will not make separate payment unless the documentation supports significantly, separately identifiable service that…

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Posted and filed under Coding, Compliance.

ER Upcoding Rules & Regulations To Be Aware Of

Does documentation of more than 50% of time spent counseling or coordinating care suffice for time documentation, and therefore E/M code level selection? Many will answer: YES Let’s take a peek at an often forgotten CMS rule “In general, to bill an E/M code, the physician must complete at least 2 out of 3 criteria…

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Posted and filed under Healthcare.

Top Oral Cancer Indicators

Oral Cancer is a growth or sore in the mouth that does not go away. Oral Cancer can be life threatening if not diagnosed or treated early. According to the American Cancer Society, men face twice the risk of developing cancer as women. Men who are over 50 face the greatest risk. It is estimated…

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Posted and filed under Compliance.

Compliance Corner – October

If a patient is deceased, may a covered entity disclose to a family member who was involved in the patient’s care or payment for healthcare prior to the death, PHI of the deceased? Answer: Yes, unless there is an expressed statement to the contrary. (45CR 164.510)

Posted and filed under Fraud, FWA.

Fraud Waste and Abuse Fact – October

Whistleblower Lawsuit Leads to Record Setting Settlement for Adventist Health System Adventist Health System will pay $118.7 million to the federal government and four states to settle a whistleblower lawsuit filed in December 2012. The lawsuit alleged that Adventist paid doctors excessive compensation for patient referrals to Adventist-owned health care facilities, including hospitals, clinics and…

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Posted and filed under Coding, ICD-10.

Top 10 ICD-10 Codes

Although the transition to ICD-10 has been difficult, due to the large amount of codes that have been added with the implementation, coders are beginning to see how beneficial this transition will be in the future. Now that ICD-10 has officially been implemented for 10 business days, our Advize Health coders and friends of Advize…

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Posted and filed under Coding, ICD-10.
icd 10 tip sheet

Advize Health ICD-10 Tip Sheet

ICD-10 is officially here and Advize Health has provided you with the top 10 ICD-10 tips when going through this transition! Be sure to keep these tips in mind when facing this implementation and learning to transition from ICD-9 to ICD-10. Download PDF

Posted and filed under Coding, Healthcare, ICD-10.

Why Are Medical Professionals Panicking?

This is an actual experience from one of our Advize Health employees. This morning I went to the doctor’s office and the entire mood of the office was different. The staff including the nurses, doctors, and PA’s was panicking and many of them appeared to be upset. Why is this?  It is October 2, 2015,…

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