News
January 28, 2020
Prior Authorization for Medical Services: A Significant Pain Point for Providers and Practices
By Terry Fletcher, BS, CPC, CCC, CEMC, CCS, CCS-P, CMC, CMSCS, CMCS, ACS-CA, SCP-CA, QMGC, QMCRC
Prior authorization is mostly a manual process. Prior authorizations are not going anywhere anytime soon, but drastic changes on how they are handled may finally be on the horizon. An April 2018 study from the Government Accountability Office found that Medicare prior authorization programs saved the program between $1.1 billion…
January 28, 2020
Single Source Physician and Facility Emergency Room Coding: What Key Elements to Consider
By Susan Gatehouse, RHIT, CCS,CPC, AHIMA-Approved ICD-10-CM/PCS Trainer
In the continuous pursuit of improved efficiencies, can single-source coding be a solution? As organizations continue to evaluate the most efficient and cost-effective ways to streamline operations, there is increasing movement toward single-source physician and facility emergency room coding. This has proven to be a successful endeavor for many organizations,…
January 28, 2020
Deadly Virus Continues to Rattle Global Healthcare Officials
By Laurie M. Johnson, MS, RHIA, FAHIMA AHIMA Approved ICD-10-CM/PCS Trainer
Coronavirus is spreading. EDITOR’S NOTE: This is a developing story and ICD10monitor will continue to update you on the latest development on this global health crisis. As of Jan. 27, eight cases of a novel coronavirus (2019-nCor) have been reported in the United States. The outbreak that started in Wuhan, China…
January 21, 2020
National Coding Contest Indicates Outpatient Coding is Getting Worse, not Better
By Holly Louie, RN, BSN, CHBME
More than 4,000 cases were coded in the 2019 contest focused on outpatient coding. ICD-10 is well-established, and we are already discussing and planning for ICD-11. However, where are the long-anticipated and promised increased accuracy and most definitive diagnoses? At least one coding contest found outpatient coding in 2019 had…
January 21, 2020
Be a Success in Your Coding Career
By Lamon Willis, CPCO, CPC-1, COC, CPC, AHIMA-Approved ICD-10-CM/PCS Trainer
Success can cost you more than you thought it would. You might have heard the phrase, “everyone wants to be successful until they see what it actually takes.” While I’m not sure where the quote originates, I’ve seen it attached to various images, one of which is the feet of…
January 21, 2020
Appropriate Use Criteria (AUC) for Advanced Diagnostic Imaging: 2020 Testing Period Officially Underway
By Susan Gatehouse, RHIT, CCS,CPC, AHIMA-Approved ICD-10-CM/PCS Trainer
Tackling processes and departmental integration requirements for AUC will be key this year. The testing phase for the Appropriate Use Criteria (AUC) Program officially began on Jan. 1, 2020. Being as there is a purely educational and operational testing period, physicians and practitioners will not be subject to any adverse…
January 14, 2020
Is Recording the Patient Encounter for Posterity a Good Idea?
By Erica E. Remer, MD, FACEP, CCDS
EDITOR’S NOTE: Dr. Erica Remer reported this story live during the January 14 edition of Talk Ten Tuesday. The following is an edited transcript of her reporting. When I do my Case Western Reserve University documentation course, I sometimes joke about the future, when we won’t need to document because the…
January 14, 2020
MedPAC Suggests Elimination of “Incident To” Billing for NPPs, APRNs, PAs, APPs, Physician Extenders, etc.
By Terry Fletcher, BS, CPC, CCC, CEMC, CCS, CCS-P, CMC, CMSCS, CMCS, ACS-CA, SCP-CA, QMGC, QMCRC
Incident-to billing for advanced practice providers or APPs (nurse practitioners, physician assistants, clinical nurse practitioners, nurse midwives, etc.) has been available to limited-license practitioners since 1998, and the rules for what is required to bill incident-to are clearly defined by the Centers for Medicare & Medicaid Services (CMS). Yet this…
