Posted and filed under Coding, Medical Record Auditing.

Overview of Colonoscopy Coding

Diagnostic Colonoscopy A diagnostic colonoscopy is a test performed as a result of an abnormal finding, sign, or symptom (such as diarrhea, abdominal pain, etc.). Factors for Consideration: Symptoms before the procedure such as a change in bowel habits, rectal bleeding, etc. Findings during the procedure (polyp, cancer, diverticulosis, etc.) Personal history of cancer or…

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Posted and filed under Coding, Healthcare.

Teaching Physician Guidelines

Billing and documentation guidelines are not the same in all 50 states. A statement such as, “I saw and evaluated the patient. I agree with the resident’s documentation,” may be acceptable in some states, but in other states, the Medicare Administrative Contractor (MAC) would consider this to be a generic attestation, and require the teaching…

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Posted and filed under Coding.

‘Tis the Season…For Proper Coding

We’ve all seen cute memes on Facebook as we scroll through our timeline; “Bitten by A Vampire? There’s a code for that!” ICD-10 S10.87XA. “Overdose on turkey? There’s a code for that!” ICD-10 E70.5 or R63.2. “Grandma got run over by a reindeer? There’s a code for that, too!” ICD-10 V06.00XA. The list goes on…

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Posted and filed under Coding.

Ambulance and EMS Transport Coding

The need for ambulatory services has seen an increase in recent years, and as a result ambulance transport claims have also risen. Payers generally cover ambulance services for patients whose medical condition is such that air transport is medically necessary. EMS Transport Coding is a unique coding set of non-physician provider services, where medical necessity…

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Posted and filed under Coding, ICD-10.

ICD-10 Codes That Will Haunt You

For a long time, ICD-10 was regarded as a nightmare for healthcare providers and their billing teams. The healthcare industry “woke up” and eventually embraced the reality of ICD-10, only to be faced with another monster; MACRA. This Halloween, we’re taking it back to more simple times and exploring the spookiest ICD-10 codes you’ll ever…

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Posted and filed under Coding, Fraud.
pain-management

Chiropractic Billing Red Flags

All insurance payers are obligated to perform routine reviews of claims submitted by providers who operate under their plans. In recent years these claims examinations have gotten more rigorous, with antifraud initiatives being pushed by private health plans and those operating under the umbrella of CMS. The prevalence of insurance fraud has created a hypervigilant…

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Posted and filed under Coding, Compliance.

Understanding the Vaccines for Children Program

Please refer to our accompanying article Vaccine Administration Counseling for more information on vaccine coding and documentation. The Vaccines for Children (VFC) Program is a federally funded program that offers vaccines at no cost for eligible children through doctors enrolled in the program. The CDC provides information for Healthcare providers to become a VFC provider….

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Posted and filed under Coding, FWA, Medical Record Auditing.

How Much Are Your Policies Costing You?

A medical record audit can reveal over-payments for up-coding, incorrect numbers of units billed, and the abuse of modifiers – just to list a few. Given the popularity of such indiscretions, what is being done after the money is recovered? Do you intend on data mining again in six months, hoping that the provider will…

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Posted and filed under Coding, ICD-10.

Zika Virus – More Than A Mosquito Sized Threat

The mosquito-borne disease known as Zika Virus has been dominating headlines across the world for several months, with doctors warning high risk populations of the symptoms and signs of the disease. The initial consensus was that while the severe symptoms are terrifying and problematic, death is a distant concern. This tune quickly changed last week,…

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Posted and filed under Coding, Events.

Advize Health Incident-To Audits Webinar Recap

On April 21, Advize Health held our monthly webinar on Incident-To Audits. Melissa Jewett, Advize Health’s QA Specialist and auditor guided attendees through the informative presentation, taking time in the end to hold an open Q&A session. Melissa is a highly qualified professional, holding both CPC and CPMA certifications from the AAPC. The presentation tackled…

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