The long-awaited update to the CT lung screening national coverage determination (NCD) was finally released this month. As you may recall, current smokers who were otherwise eligible were omitted from the NCD-covered codes released last year. That is the really good news. The really bad news is that at least…

EDITOR’S NOTE: This article has been written in recognition that May was National Cystic Fibrosis Awareness Month. More than 33,000 people in the United States are affected with cystic fibrosis, with 1,000 new cases of the genetic disease diagnosed each year, according to the Cystic Fibrosis Foundation.Surprisingly, at least half of…

In some quarters of healthcare, 2015 was the year of the big malaise. Although former President Jimmy Carter never actually uttered the word in his July 1979 speech about a “crisis of confidence,” his comments ultimately become known as the “malaise speech.”

Chiropractors use many of the same diagnosis codes as other providers that treat conditions of the nervous system, skeletal system, and muscular system. However, there is one diagnosis that’s unique to chiropractic doctors. It is the so-called vertebral “subluxation.” It is the diagnosis that justifies the performance of a chiropractic…

Here are some lessons learned over the last year as we have prepared for an organization-wide approach to implementing ICD-10 across a very large health system in San Diego. There are three specific areas that should be considered when  implementing a new coding process for hospice programs, which went into…

During recent months I have heard many references to Oct. 1 and ICD-10, but there have been fewer than expected following implementation of the new coding set. I was pleasantly surprised by the quiet. It was a good feeling, a feeling of accomplishment, knowing that all of us in the…

Although ICD-10 implementation has gone amazingly well, there are specialty-specific challenges arising for some practices and groups. For example, orthopedics has an incredibly large list of extremely specific codes. That can be very frustrating for physicians who must treat patients when it is not their primary or only specialty, and they may…

Under ICD-10, submitting compliant and accurate claims and minimizing the negative impact to clients’ cash flow were concerns shared by all those in the coding and medical billing community. While the transition has been relatively smooth as it pertains to our internal operations, there have been unanticipated challenges on the…

ICD-10 has been a non-event for clearinghouses, which are continuing to report little impact on their day-to-day business operations. Availity, one such entity, has encountered a few minor issues over the past month, primarily related to data not being submitted correctly by providers or payers having slightly different interpretations of…

As we begin coding inpatient rehabilitation facility (IRF) claims using ICD-10, it is prudent to review Medicare’s clarification about the use of seventh-character extension in ICD-10-CM under the IRF Prospective Payment System (PPS). Earlier this year, the Centers for Medicare & Medicaid Services (CMS) issued the following clarification related to…