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Latest articles

Present on Admission POA Indicator
November 26th, 2018 - BC Advantage
This article will focus on the Present on Admission (POA) indicator which is used as a method of reporting whether a patient’s diagnoses are present at the time they are admitted to a facility. We’ll look at a few scenarios to determine the correct reporting of POA and the impact...
Billing 99211 Its not a freebie
November 9th, 2018 - BC Advantage
It seems like a simple code to bill, but CPT 99211 (established patient office visit) is by no means a freebie when it comes to documentation and compliance. This lowest level office visit code is sometimes called a "nurse visit" because CPT does not require that a physician be present...
Muscle Testing and Range of Motion Information
November 8th, 2018 - Wyn Staheli, Director of Research
Be sure to understand the unique code requirements for Muscle and Range of Motion Testing.
Medi-Cal Coverage Criteria for Hospital Beds and Accessories
November 7th, 2018 - Raquel Shumway
Medi-Cal coverage of child and adult hospital beds and accessaries. What is covered and what documentation is required.
Are you Ready for CMS' 2019 Medicare Physician Fee Schedule Final Rule?
November 7th, 2018 - Wyn Staheli, Director of Research
The waiting is over, the Final Rule for CMS' 2019 Medicare Physician Fee Schedule (MPFS) is available - all 2,379 pages for those looking for a little light reading. As anticipated, there are some pretty significant changes. Most of us were carefully watching the proposed changes to the Evaluation and ...

Editors choice articles

Billing 99211 Its not a freebie
November 9th, 2018 - BC Advantage
It seems like a simple code to bill, but CPT 99211 (established patient office visit) is by no means a freebie when it comes to documentation and compliance. This lowest level office visit code is sometimes called a "nurse visit" because CPT does not require that a physician be present...
Are you Ready for CMS' 2019 Medicare Physician Fee Schedule Final Rule?
November 7th, 2018 - Wyn Staheli, Director of Research
The waiting is over, the Final Rule for CMS' 2019 Medicare Physician Fee Schedule (MPFS) is available - all 2,379 pages for those looking for a little light reading. As anticipated, there are some pretty significant changes. Most of us were carefully watching the proposed changes to the Evaluation and ...
We've Always Done It This Way and Other Challenges in Education
October 19th, 2018 - BC Advantage
As coders, auditors, and compliance professionals, we are the provider's advocates in closing the gap between what is medically necessary and what is required for documentation. Sometimes that places us in the role where we need to save our clinicians from themselves, and the patterns they have fallen into...
HCC - Acceptable Provider Interpretation for Diagnostic Testing
October 1st, 2018 - Wyn Staheli, Director of Research
The following table is taken from the Contract-Level Risk Adjustment Data Validation Medical Record Reviewer Guidance dated 2017-09-27 (see References). It is a listing of acceptable provider interpretation of diagnostic testing. Acceptable Examples include: Cardiology and Vascular Surgeons Echocardiogram (including Doppler, Duplex, Color flow of the heart vessels) EKG (electrocardiogram) – Stress test, Cardiac ...
The Potential Impacts of a Flat Rate EM Reimbursement on our Industry
September 26th, 2018 - BC Advantage
The proposed E&M changes by CMS would decrease provider administrative work burden by, per CMS, 51 hours a year; however, how will reducing documentation requirements truly affect the professionals of the healthcare industry? First, let’s discuss the 30,000-foot overview of the most impactful E&M changes—which is the change to the...

Latest questions/posts

Hospitalist and specialist billing E/M on same day
   Dec 11th, 2018 - rdinaso    12  1 

93351 in office Stress Echo billing question
1st    Dec 6th, 2018 - JL81

Ordering and obtaining precert/prior auth for Motility Studies @ the hospital
1st    Dec 5th, 2018 - Denise J   

Attempted ERCP
1st    Nov 16th, 2018 - Emmi

Z code
   Nov 16th, 2018 - rdinaso    12  1 

Cannabis oil as an alternative medicine
1st    Oct 31st, 2018 - Kirsti090

Chopart Amputation Revision
1st    Oct 30th, 2018 - Hgorby

J0171 - Epinephrine Epi Pen - Help please
   Oct 19th, 2018 - Mand0984 11 

CPT code for nephrology capitation billing to arkansas Medicaid
   Oct 17th, 2018 - anitac

Outcome Assessment Tools
1st    Sep 14th, 2018 - DrEd

NHP-RI CPT 64450-XS denied as non coverd
   Sep 11th, 2018 - austin

Diabetic Foot Care
   Aug 28th, 2018 - alleegator13

Hiv - 2
1st    Aug 21st, 2018 - Jstew

MDM credit in Table B
   Aug 17th, 2018 - damills 1 

Grouping of mutually exclusive CPt4 in IR DRG
1st    Aug 17th, 2018 - Hhiba

Denial in question
   Aug 15th, 2018 - alleegator13

Incident To Billing
   Aug 14th, 2018 - dlstoner512 1 

Reimbursement Question for J2785 - Injection, regadenoson, 0.1 mg
1st    Aug 13th, 2018 - Jaywalkz

CPT 61510 and 61518- multiple tumors
   Aug 12th, 2018 - LBAROGIANIS 250 

ICD-10 - Help
   Aug 7th, 2018 - precod 10 


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