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Latest articles

VA Expands Telehealth
June 14th, 2018 - Wyn Staheli, Director of Research
On May 11, 2018, the Department of Veterans Affairs (VA) released its final rule on the "Authority of VA Health Care Providers to Practice Telehealth." Effective June 11, 2018, VA providers will be able to provide telehealth services across state lines. This move will make it easier for veterans to obtain ...
Will Medicare's Proposed Reformations Affect Your Practice?
June 12th, 2018 - Wyn Staheli, Director of Research
Recently, Medicare's Innovation Center released an informal Request for Information (RFI) seeking input on several different system reformation proposals. As the market moves towards more value based payment systems, innovation and new models are being sought to both reduce costs and increase quality. This article outlines the ideas presented in the ...
Inappropriate Use of Units Costs Practice Over $800,000
June 11th, 2018 - Wyn Staheli, Director of Research & Aimee Wilcox, CPMA, CCS-P, CMHP, CST, MA, MT
A recent OIG enforcement action emphasizes the need to understand the proper use of units. A healthcare provider in Connecticut improperly submitted multiple units for drug screening urine tests. The proper billing of units has proven to be problematic for more than just lab tests. Is your billing of drugs & biologicals, injections and timed codes appropriate?
Coding for Strains in ICD 10
May 30th, 2018 - BC Advantage
According to the National Institutes of Health, a review was carried out on 20 patients who had a pectoralis major muscle repair between 2003 and 2011, and the results were as follows....
AMA vs Medicare rules and the use of the PT modifier
May 22nd, 2018 - Chris Woolstenhulme, QCC, CMCS, CPC, CMRS
Be sure to review the specific payer policy you are submitting claims to. 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. The use of the PT modifier is ...

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

VP tie off
   Jun 22nd, 2018 - lizzg

Axillary artery cutdown
1st    Jun 20th, 2018 - dll

Mesh removal in office
1st    Jun 13th, 2018 - Nikkibear

Initial patient eval with medical services
1st    Jun 12th, 2018 - Andrea58

CPT code for Colon hydrotherapy
1st    Jun 7th, 2018 - daltonl

ERCP Coding
   May 31st, 2018 - Roxanne W    1 

Office visit with Provider and Nurse Only lab, same DOS
   May 30th, 2018 - sschwartz 3 

DERMATOLOGY - Muscle, myocutaneous, or fasciocutaneous flap; CPT 15733
   May 30th, 2018 - gowri.tina

   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 1 

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


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