Posted and filed under Careers, Coding.

5 Things You Need to Know About Becoming a CPC

Strategy is Key Becoming a Certified Professional Coder is no easy feat, and the exam administered by the American Academy of Professional Coders (AAPC) is a long, grueling assessment. Of course, the exam will present CPCs-to-be questions on CPT codes, Evaluation and Management, the bodily systems, and the application of multiple code sets – but…

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Posted and filed under Medical Record Auditing.

The Importance of Medical Necessity in Medical Coding

Medical necessity documentation, or lack of it, is one of the most common reasons for claim denials. For a service to be considered medically necessary, it must be reasonable and necessary to diagnosis or treat a patient’s medical condition. When submitting claims for payment, it is the diagnosis codes reported with the service that tells…

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Advize Health’s Prepayment and Postpayment Reviews Webinar

Advize Health will take you step by step through several real life audit example from data selection to extrapolations and recoveries. Find out common pitfalls and areas of your policies and procedures that could be tighten up to guard against FWA. We will present the differences between a postpayment audit and a prepayment audit and…

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Posted and filed under Medical Record Auditing.

The Benefits of DRG Validation

DRG validation is a tool that can be used to reduce risk, defend claims, and ensure the accuracy of the coded items. The purpose of DRG validation is to confirm that diagnostic, procedural information, and the discharge status of the beneficiary, as coded and reported by the hospital on its claim, matches both the attending…

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

Vaccine Administration Counseling

Vaccine administration coding and documentation is often confused by many providers, billers, coders, and even auditors.  One misunderstanding is what exactly is a toxoid component? And what documentation is necessary to support billing vaccine administration with counseling?  Here’s a quick look at the codes we are talking about. A toxoid component according to CPT refers…

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