News

Understanding why a culture of compliance in coding and documentation is so important. Compliance is a large part of our duties in healthcare. It is especially true for coding. With so many regulations, the audit atmosphere and payment nightmares, quite simply we are a moving target. For those of us…
“Virtual" peer reviews are a covered benefit for most payers. In keeping with our theme of “communication-based services,” let’s take a closer look at the inter-professional consults and referrals that do not include a face-to-face encounter with a patient. Some are existing CPT® codes, and two new codes, in this…
CMS has released the inpatient psychiatric facility proposed rule. Approximately $75million is projected to be paid to inpatient psychiatric facilities (IPF), according to the Centers for Medicare & Medicaid Services (CMS) proposed 2020 inpatient prospective payment system (IPPS) released on April 19. IPF-PPS applies to inpatient services for psychiatric hospitals…
Documenting challenges with EHR usage. At the beginning of the month, I attended an interesting conference through Case Western Reserve University School of Medicine called, “Electronic Health Records and Patient Safety: Legal Challenges and Solutions.” I am going to unpack it for you in a two-part series. I have included…
April showers bring social determinants of health flowers The showers of April have brought a burst of blooms in the Social Determinants of Health (SDoH) reimbursement garden. First, the Centers of Medicare and Medicaid Services (CMS) released its 2020 rate sheet. As expected by the industry, Medicare Advantage and Part…
Body mass index is a heavy topic. Spring has arrived in the Northeast and people are getting back to their exercise schedules. I was thinking about this topic as I was reading Coding Clinic, Fourth Quarter 2018. One of the big topics in this issue is body mass index (BMI)…
CAC is not AI. I know that numerous articles and even some books have listed the pros and cons of artificial intelligence (AI). Discussion of the technology in relation to computer-assisted coding (CAC) dramatically ramped up with the implementation of the 10th version of the International Classification of Disease (ICD)…
Bypassing the bypass guidelines for the coronary and peripheral arteries Forget the coding guidelines (at least temporarily) – let’s focus on the procedures first. The classic first step in coding is to read the guidelines, but in the case of many ICD-10-PCS guidelines, starting there may prove to be confusing…