by Advize Admin | Dec 28, 2015 | Coding
Health plans that want to “do” HEDIS should anticipate its common stumbling blocks — and take steps to overcome them. The following are some key hurdles that health plans face when preparing HEDIS data: What is HEDIS? When the physician staff begin to...
by Advize Admin | Dec 16, 2015 | Coding, Medical Record Auditing
There are many techniques to extracting data that can range from reviewing claim line billing data to actual medical record reviews. Relying exclusively on the claims data to analyze and identify atypical billing patterns or potential red flags is always challenging....
by Advize Admin | Dec 10, 2015 | Coding
Providers with a Primary and Secondary Specialty National Government Services Every healthcare provider has at least one taxonomy code that reflects his or her specialty. Esure that your provider’s specialty is accurately represented by this. Medicare Part B providers...
by Advize Admin | Dec 4, 2015 | Coding
Wound repairs require determining three separate components before selecting the appropriate CPT code: Layer – What is the depth/complexity of the wound repair? Location – Where on the body is the wound? Length – How long in centimeters is the wound repair? Layer...
by Advize Admin | Nov 19, 2015 | Coding
As we all know, medical coding can be a fast-paced, high-intensity job, and with that comes high stress. A typical coder has a bulky workload and is responsible for ensuring that they are up-to-date with industry changes. Furthermore, the majority of coders wear...
by Advize Admin | Nov 19, 2015 | Coding
The Centers for Medicare & Medicaid Services (CMS) released, Sept. 25, a proposed rule that will significantly revise the Medicare payment system for clinical diagnostic laboratory tests (CDLTs) and advanced diagnostic laboratory tests (ADLTs) paid under the...
by Advize Admin | Nov 5, 2015 | Coding
Your group just merged with another practice, are these considered patient’s new or established? With mergers and acquisitions so frequent in the healthcare industry, it’s important to be aware when faced with these issues and knowing what to do with your patients...
by Advize Admin | Oct 29, 2015 | Coding
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...
by Advize Admin | Oct 27, 2015 | Coding, Healthcare
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,...
by Advize Admin | Oct 27, 2015 | Coding, Compliance
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...
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