November 24, 2020
How to Practically Implement a CCM Program
Participation in a CCM program by primary care physicians remains low. Now that we appreciate the numerous benefits of starting a chronic care management (CCM) program, both from the standpoint of patient care and reimbursement, while acknowledging some of the reasons behind the hesitation among some providers to initiate one,…
The federal agency has recommended that healthcare workers self-report symptoms and not work if ill. EDITOR’S NOTE: On March 5, the Centers for Disease Control and Prevention (CDC) held a call to update the provider community on the latest guidance related to COVID-19. During the call, several CDC physicians described…
November 26, 2019
Change is Coming for E&M: Start Preparing Now for 2021
E&M codes are the most frequently used codes in any physician practice. Change is coming to the world of evaluation and management (E&M) services. With the Physician Fee Schedule Final Rule for 2020 now published, we know there are big changes to be expected in 2021. The good news is…
October 1, 2019
When Official Coding Guidelines Could be Confusing
Do your physicians and ancillary staff know the ICD-10-CM coding rules? Based on many years of personal experience, most physicians and ancillary staff who do not code really don’t know or understand the coding rules. This is not particularly surprising, because even the best coders are sometimes confused by the…
September 26, 2016
Are New Coding Guidelines Letting Physicians off the Hook?
Over the many weeks since the release of the updates to the ICD-10-CM Official Coding Guidelines for the 2017 fiscal year, I have had the opportunity to engage in multiple conversations about the most controversial guideline, which addresses the use of clinical indicators for code assignment. Some of those conversations…
August 8, 2016
Medical Assistants Add Value for Physician Offices
Physicians can benefit from the talents of their medical assistants, and possibly in areas other than ICD-10.Medical assistants (MAs) are typically members of physician office teams. If certified, these individuals have completed a structured education program with courses in anatomy, medical terminology, coding, and disease processes. They are among the…
March 28, 2016
Physicians as Administrators
One of the biggest lingering questions facing the healthcare industry today is this: how do we keep physicians from becoming administrators rather than clinicians?Having a quality clinical documentation improvement (CDI) program in place can grant physicians the necessary flexibility and time to dedicate to their patients while still providing an…
March 14, 2016
Problematic Diagnoses
As I was listening to a recent broadcast of Monitor Mondays, I was a bit taken aback when I thought I heard the phrase “the physician writes down the diagnosis, and it should be accepted as the diagnosis.”
February 22, 2016
Far Reaching Impact of Functional Quadriplegia
Functional quadriplegia (R53.2) is defined as “the inability to move due to severe disability or frailty caused by another condition without physical injury or damage to the brain or spinal cord,” describes Richard Pinson, MD. This oft-overlooked secondary diagnosis may have significant impact on the final MS-DRG, relative weight, length…
February 1, 2016
Combating Opioid Addictions and Overdoses with Coded Data
The statistics are striking: Between 2002 and 2013, heroin overdoses in the United States increased by 286 percent, according to a Centers for Disease Control and Prevention (CDC) report. In 2013 alone, more than 8,200 Americans died due to a heroin-related overdose.