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 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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Posted and filed under Coding, Healthcare.

Clearing Up Some Eye Exam Confusion

How are eye exam codes defined? CPT includes four codes that specifically describe eye exams: 92002:  Medical exam and evaluation with initiation of diagnostic and treatment program; intermediate, new patient. 92004:  Medical exam and evaluation with initiation of diagnostic and treatment program; comprehensive, new patient, one or more visits. 92012:  Medical exam and evaluation with…

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Posted and filed under Coding, ICD-10.

Are you Ready for the Shift to ICD-10?

On July 31st, 2014, the U.S. Department of Health and Human Services (HHS) issued a rule finalizing Oct.1, 2015 as the new compliance date for health care providers, health plans, and health care clearinghouses to transition to ICD-10, the tenth revision of the international Classification of Disease. ICD-10 will provide an enhancement platform for physician…

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Posted and filed under Coding, ICD-10.

Top 5 Reasons to Get Your ICD-10 Certification

5. If your employer does not currently require ICD-10 proficiency they likely will in the very near future. As we all know, ICD-10 is quickly approaching and it’s being implemented on October 1st. This is the system that everyone is going to be required to use, which is why it’s so crucial that all healthcare…

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Posted and filed under Coding, Compliance.

Medicare Guidance for Mid-Level Providers

Taking the Guesswork out of Correct Billing More and more health organizations are hiring midlevel providers to perform services that were formerly thought to be appropriate exclusively for medical physicians. While it is less costly to hire Physician Assistants, Nurse Practioners, and Certified Nurse Midwives, it’s imperative that institutions familiarize themselves with the rules regarding…

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Posted and filed under Coding, Healthcare.

Chiropractic Coding

Many years ago when I first began my career in the health field I worked for a chiropractic office as I was becoming familiar with their computer system, codes, and billing forms I had a lot of questions! Over 15 years, work on a bachelors degree and multiple coding and billing certifications later, I realize…

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