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Most-used codes by POS show Albuterol a hit at home

05/20/2019

You may be surprised to learn that the place of service (POS) with the most-claimed code under Medicare would be 12 (home) rather than 11 (office) or 21 (inpatient hospital). But that’s where the lion’s share of Medicare’s biggest code is billed. And the number of services claimed for home overall stretches into 10 figures.

Review Open Payments data for accuracy, fee analysis before deadline hits

05/13/2019

by: Richard Scott

Mark your calendar to review the payments that health care suppliers and manufacturers made to you — or say they did. You’ll have until May 15 to initiate a review of the federal Open Payments program data and dispute any errors.

Great communicator with a flair for management? Run your own bundles and save

05/13/2019

by: Roy Edroso

As a bundler of episodes of care for private payers, you could make a substantial amount of money — but you have to tick a lot of boxes before you take on your first patient to avoid potentially costly mistakes.

Proposed 2020 ICD-10-CM codes cover deep tissue damage, fractures & more

05/13/2019

by: DecisionHealth Staff

Coders will have new ICD-10-CM codes to report pressure-induced deep tissue damage, acute versus chronic embolism and thrombosis and fractures of the facial bones around the eye, among other changes.

Small coding error costs big money; poor coder training suspected

05/13/2019

by: Roy Edroso

The danger of a simple coding gaffe was made clear recently by a DOJ settlement in which a cardiology practice had to pay nearly $400,000 for claims with a faulty combination of two test codes.

Bonus shot: Speaking, training pace $8 billion in financial contributions to providers

05/13/2019

by: Richard Scott

Beyond normal salary figures, the nation’s physicians and teaching hospitals reaped more than $8 billion in payments in 2017 from companies such as drugmakers and device manufacturers, according to data from the CMS-operated Open Payments program.

Try high tech, high touch to urge slow-paying patients into the fast lane

05/06/2019

by: Roy Edroso

A recent survey shows that providers are having serious trouble getting timely payments from patients — and while high-deductible plans are, as usual, a suspected culprit, experts suggest that a more high-touch, high-tech approach from providers could help take up some of the slack.

Button down your infection control as measles, HAV outbreaks spread

05/06/2019

by: Roy Edroso

Recent measles outbreaks in the United States are a grim reminder that infection control is a matter of practice policy and should be reinforced at intervals to keep it effective.

Sharpen your CPT and ICD-10-CM coding for prostate cancer, PSA testing

05/06/2019

by: Shelley C. Safian, PhD, RHIA, CCS-P, CPC-I

Prostate cancer is the second most common form of cancer in American men, according to the American Cancer Society. The organization estimates that in 2019 more than 174,000 Americans will be diagnosed with prostate cancer and more than 30,000 will die from it.

Focus on opioid review regardless of history, prescriber when reporting AWVs

05/06/2019

by: Richard Scott

Question: Regarding the recent updates from CMS, do we need to document “opioid review” in the wellness visit note if the patient has not recently been on opioids? We have a general “drug use” question on our wellness forms but nothing specific to opioids. Secondly, if the patient is on opioids prescribed by another provider, do we need to document opioid review? When our providers prescribe opioids, we always document review, alternative treatment, failed treatment, etc., so that is not a concern.

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