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Latest articles

CMS Compliance Guidelines Focused Trainings
April 9th, 2018 - Christine Woolstenhulme, QCC, CMCS, CPC, CMRS
Since the publication of the Compliance Program Guidelines in 2012, the Medicare Part C & D Oversight and Enforcement Group, Division of Compliance Enforcement, has presented a series of focused trainings for the industry on the application of the seven elements of an effective compliance program. These trainings are designed ...
Home Oxygen Therapy – Medical Record Requirements
March 27th, 2018 - Raquel Shumway
Medical Records must contain sufficient documentation to substantiate the need for Home Oxygen Therapy. Information to be included in the documentation.
Home Oxygen Therapy – Written Order Prior to Delivery (WOPD)
March 27th, 2018 - Raquel Shumway
A Written Order (Prescription) Prior to Delivery (WOPD) must be provided to the supplier BEFORE the supplier delivers the oxygen and/or equipment to the patient. The WOPD may be completed by an employee of the physician, but the physician must review, sign, and date the WOPD. An NP, CNS, or PA may...
Q/A: Which Modifiers to Use When Billing 44005 and 36556 Together
March 26th, 2018 - Chris Woolstenhulme QCC, CMCS, CPC, CMRS
I have a denial for 44005 and 36556 being billed together. I added modifiers 51, 59, and Q6 to 36556 but I am afraid it will deny again?
Q/A: Billing for GI Anesthesia
March 21st, 2018 - Chris Woolstenhulme, QCC, CMCS, CPC, CMRS
Medicare’s policy requires the use of a different code when a screening colonoscopy becomes a diagnostic procedure requiring you to bill with CPT code 00811 when treating a Medicare Beneficiary.

Editors choice articles

Health Care Fraud - Don’t Do It!
July 31st, 2017 - Chris Woolstenhulme, CPC, CMRS
If you wonder if what you are doing is fraud, DON’T DO IT! The government takes this extremely serious. I don't need to tell you this.  I have often been apprehensive about making a mistake and I wonder, will it be fraud? Will I spend time in jail for accidentally sending in a duplicate ...
Pre-op visits: True or False?
December 29th, 2015 - Codapedia Editor
Are the following statements true or false? • The PCP cannot be paid to do a pre-op assessment of a Medicare patient prior to surgery because of the new consult rules. • The surgeon can never be paid to do a pre-op visit if s/he is going to take the patient to surgery. • The...
Billing Incident to Services-Whose Number Should Be Used?
December 29th, 2015 - Seth Canterbury, CPC, ACS-EM
Should You Bill Incident to Services for a Medicare Patient Under The Number of the “Supervising Physician” or the “Ordering Physician”? This issue was first clarified in the preamble of the 11/1/01 Federal Register (available here on p. 23 of the file, p. 55267 of the...
Cloned E/M notes
December 29th, 2015 - Codapedia Editor
Have you ever read a physician office note and thought it was strangely familiar? Or, not just familiar but identical to another note? Well, Medicare contractors have noticed the same thing, and the Office of Inspector General has included this on their 2011 Work Plan. Medicare contractors have...
Cardiology Coding Unmasked - Part 2 Therapeutic Cardiology Procedures, CPT Codes (92980-92982; 92984; 92995-92996), Medical Necessity Issues (ICD-9-CM)
December 29th, 2015 - Nancy Maguire
92980 Transcatheter placement of an intracoronary stent(s), percutaneous, with or without other therapeutic intervention, any method; single vessel 92981 Transcatheter placement of an intracoronary stent(s), percutaneous, with or without other therapeutic intervention, any method; each additional...

Latest questions/posts

   May 24th, 2018 - sschwartz 3 

1st    May 24th, 2018 - CoderRich

Not accepting insurance company at one site but not others?
1st    May 19th, 2018 - cbchun

Arkansas Medicaid capitation CPT code
   May 16th, 2018 - anitac

ORIF radial head AND neck
1st    May 11th, 2018 - carsil864

Opertative Report
1st    May 8th, 2018 - stepyg

Umbilical cord clamp removal
1st    May 3rd, 2018 - Latisha

CPT code for dialysis physician capitation charge
   May 3rd, 2018 - anitac

Leison removal and repair
   Apr 27th, 2018 - sharris

Medicare Services Denied
   Apr 26th, 2018 - alleegator13

1st    Apr 23rd, 2018 - tswelch

Diabetic visits
   Apr 17th, 2018 - alleegator13

Injections and modifiers
   Apr 17th, 2018 - alleegator13

Repairs after lesion removal Under 1cm and .5cm and under
   Apr 12th, 2018 - sharris

   Mar 29th, 2018 - Ortho 1 

Dura Repair
1st    Mar 29th, 2018 - lizzg

BCBS improper use of modifier denial
1st    Mar 28th, 2018 - lisacaroltex

Prompt Pay Discount Policy
   Mar 28th, 2018 - Roxanne W   

Sinus Tract
1st    Mar 27th, 2018 - Ortho 1 

Undermining - Simple - Intermediate - Complex
   Mar 27th, 2018 - sharris


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