by Advize Admin | Feb 16, 2016 | Medical Record Auditing
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...
by Advize Admin | Feb 3, 2016 | Coding
As temperatures continue to drop this winter season, the number of runny noses and sneezes keeps on climbing. Flu season is still going strong, persevering through the flurry of snow storms and keeping people in bed for up to two weeks at a time. If you have a child,...
by Advize Admin | Jan 13, 2016 | Coding, Healthcare
CPT Defines critical care as the direct delivery, by a physician(s) or other qualified health care professional, of medical care for a critically ill or critically injured patient. A critical illness or injury acutely impairs one or more vital organ systems in such...
by Advize Admin | Jan 13, 2016 | FWA
Recently, the U.S. Government has been undertaking regulatory activities to drive down healthcare costs and improve patient outcomes. It is crucial to keep an eye on published regulations. One of the Centers for Medicare and Medicaid Services’ (CMS) key goals is to...
by Advize Admin | Dec 30, 2015 | Coding
New Year, New CPT Codes! CPT’s New Year’s Resolution isn’t to trim the fat, in fact, it’s expanding! New codes are being added for a variety of services as a result of data collected by the AMA. These new CPT changes are conducive to bundling...
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 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 | Dec 3, 2015 | Medical Record Auditing
When the work required to provide a service is substantially greater than typically required, it may be identified by adding modifier 22 to the usual procedure code. The role of the 22 modifier is to reflect additional work that is not typically part of the procedure,...
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...
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