Posted and filed under Compliance, Healthcare.

What to Watch Out For With Credit Balance

In May 2014, the Department of Health and Human Services, Office of Inspector General (OIG) published a proposed rule updating its regulations. The proposed rule will authorize civil monetary penalties for “failure to report and return a known overpayment,” among other issues.   The rule has outlined the penalty for failure to report and return overpayments…

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Posted and filed under Healthcare.

What is the Underlying Cause of Tooth Decay?

Our diet! Tooth decay results from the acid produced when sugar and oral bacteria in the mouth combine and feed off each other. Frequently consuming foods higher in acid content can lead to irreversible dental erosion.  Dental erosion is the breakdown of the tooth’s structure; the outer layer called enamel.  Dental enamel is the thin…

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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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Posted and filed under Coding, Healthcare.

Enlight-10-ment: August

Digestion of Digestive Codes The digestive system is made up of the gastrointestinal tract. Digestion begins in the mouth with chewing the food, and ends in the small intestine; its unique function is to breakdown and process the food we eat, while removing unused products for waste disposal. The body then absorbs these smaller particles…

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Posted and filed under Coding, Compliance, Healthcare.

How ICD-10 is Like Trying to Eat an Elephant in One Bite

This past week, one of our auditors, Robert Blizzard, presented to the Central Florida Physician’s Alliance in Lakeland.  There were 7 practices represented at this particular presentation.  He was asked “ICD-10 is like trying to eat an elephant in one bite.  If you were to make 3 recommendations for practices to enact right now, what…

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Posted and filed under Coding, Healthcare.

Enlight-10-ment: July

An Overview of the Genitourinary System The genitourinary system includes the reproductive and the urinary excretion organs. These are grouped together because of their proximity to each other. The structure of the urinary tract includes the kidneys; two ureters, which are the tubes leading from the kidney to the bladder and the urethra, which is…

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Posted and filed under Healthcare.

The Realities of Snoring and its Long-Term Effects

Snoring is often laughed about, but it is no joking matter. Chronic loud snoring, waking up choking or gasping for air, and cessation of breathing while sleeping for short periods of time are common symptoms of a condition called obstructive sleep apnea.  Sleep apnea affects nearly 22 million Americans, and according to the Cleveland Clinic,…

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Posted and filed under Coding, Compliance, Healthcare.

How to Code Transitional Care Management

Transitional Care Management (TCM) codes are used to report patients who are transitioning from inpatient hospital, observation, skilled nursing/nursing facility, or rehabilitation to the patients’ normal community settings such as their home, domiciliary, rest home or assisted living settings. The patient’s transition to a normal community setting is not the only requirement of the TCM…

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Posted and filed under Coding, Healthcare.
health revenue

Mining for Revenue: Turning 15 Cents into an HMO Dollar

Like most clinics, your office has probably decided to accept Medicare Advantage plans by now. So what is your plan of attack? Most providers are going to say that it is time to get each patient enrolled in these plans into the office for the all-important health assessment. Most office managers are going to prepare…

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Posted and filed under Coding, Healthcare.
stethoscope

History of Present Illness: Severity

Severity is a statement or a rating of intensity (0-10) from the patient that indicates the degree or measurement of how bad the chief complaint is. This rating not only is documented based on 0-10 scale, but it can be captured using phrases such as: worsening, improving, and increasing. An auditor performing a medical necessity…

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