YES HIM Consulting, Inc. Your Consulting Firm for Auditing, Coding and Education

HIM & Coding Education

Spinal Fusion Procedures

Refresh With YES: CPT Spinal Fusion Procedures Spotlight | 1 CEU

By YES HIM Consulting / April 2, 2020 / 0 Comments

YES HIM Consulting partners with leading industry experts and nationwide-recognized educators to provide cutting-edge education to our coders, auditors, and clients. We provide the most up-to-date content with a practical approach compliant with latest HIM & coding guidelines. The CPT Refresh With YES webinar series provides refresher courses for coders and auditors. These courses offer a practical review of complex CPT topics, provided by our nationally recognized educators and our YES HIM Executive team. The Refresh With YES: CPT Spinal Fusion Procedures webinar consists of 12-18-minute modules that examine Spinal Fusion procedures and topics.

Read More
COVID-19 Code

Selecting the Right COVID-19 Code: Should You Use CPT or HCPCS?

By Teri Jorwic / April 1, 2020 / 0 Comments

On March 11, the World Health Organization (WHO) issued a declaration of the COVID-19 as a global pandemic. Two days later, the AMA announced the development of a specific code for laboratory testing for the coronavirus, code 87635 (AMA, 2020). The Centers for Medicare and Medicaid Services (CMS) released two new HCPCS codes for coronavirus testing for Medicare claims. The reporting for COVID-19 testing is dependent on the payer, either an HCPCS or CPT code should be used; there should not be more than one COVID-19 testing code on a given claim.

Read More
Respiratory Diagnoses

Refresh With YES: ICD-10-CM Respiratory Diagnoses Spotlight | 1 CEU

By YES HIM Consulting / March 27, 2020 / 0 Comments

YES HIM Consulting partners with leading industry experts and nationwide-recognized educators to provide cutting-edge education to our coders, auditors, and clients. We provide the most up-to-date content with a practical approach compliant with latest HIM & coding guidelines. The ICD-10-CM Refresh With YES webinar series provides refresher courses for coders and auditors. These courses offer a practical review to complex ICD-10-CM topics, provided by our nationally recognized educators and our YES HIM Executive team. The Refresh With YES: ICD-10-CM Respiratory Diagnoses webinar consists of 15-21 modules that examine Respiratory diagnoses, such as COPD, Respiratory Failure, Pneumonia, and Asthma.

Read More
COVID-19 MS-DRG Assignment

New COVID-19 MS-DRG Assignment, Effective April 1

By YES HIM Consulting / March 24, 2020 / 0 Comments

ICD-10-CM code U07.1 COVID-19 will be in effect as of April 1 in the US, which was pushed up from the normal effective date of October 1 for new codes. The reasoning for this unprecedented change is for the urgent need of immediate data collection. CMS has released a new update on 3/23/2020: “The ICD-10 MCE Version 37.1 R1 uses edits for the ICD-10 codes reported to validate correct coding on claims for discharges on or after April 1, 2020″ (2020). The ICD-10 MS-DRG Grouper software package to accommodate this new code, Version 37.1 R1, is effective for discharges on or after April 1, 2020.

Read More
Coding

An Introduction To Medical Coding & Basic Terminology

By YES HIM Consulting / March 23, 2020 / 0 Comments

Medical coding is the process of assigning numeric or alphanumeric codes to the diseases, injuries, treatments, and procedures that healthcare providers perform to record each encounter accurately and correctly bill the patient (Healthcare Business & Technology, 2019). Medical coding directly ties into medical billing, which includes “preparing billing claims and submitting them to insurance providers,” as noted in our previous article, “What Is Medical Coding and Billing? How Does It Streamline a Hospital’s Financial Performance?” Ensuring the encounter was coded correctly with the right terminology is essential for correct payment and an accurate patient medical history.

Read More
COVID-19 code

Update: New ICD-10 Code For COVID-19 Effective April 1

By Teri Jorwic / March 18, 2020 / 0 Comments

The United States will begin using code U07.1 COVID-19 as of April 1 – rather than the usual effective date for new codes of October 1. This new code is being fast-tracked to allow for the urgent need of immediate data collection. Interim coding guidelines from the CDC are still to be used between now and the effective date (CDC, 2020). Review our previous article, “Coding for Coronavirus Outbreak: Interim Guidance from the CDC,” for additional information about code U07.1.

Read More
COVID-19

Medical Coding & Billing Tips for COVID-19

By YES HIM Consulting / March 16, 2020 / 0 Comments

With the number of COVID-19 (2019-Novel Coronavirus) cases expected to rise in North America, the Centers for Medicare & Medicaid Services (CMS) has provided information on how to medically code and bill all encounters related to COVID-19 for Medicare beneficiaries (CMS, 2020).

Read More
E/M

Increase Revenue & Lower Compliance Risk With These 6 E/M Tips

By YES HIM Consulting / February 20, 2020 / 0 Comments

Selecting the right E/M code can be tricky – and sometimes, costly – business. On the one hand, the coder does not want to choose a diagnosis that’s too high, which could potentially incur audits or claims denials. But, if the coder selects a code that’s too low, there’s a chance of losing revenue for his or her organization. According to Medical Economics, “payers and auditors use a quantitative scoring process that requires specific elements (i.e., history, exam, and medical decision-making [MDM] – or time spent counseling and coordinating care) for each E/M level” (2020).

Read More
Medicare Payment Systems

Top 8 Changes Medicare Payment Systems Will See In 2020

By YES HIM Consulting / February 13, 2020 / 0 Comments

The Centers for Medicare & Medicaid Services (CMS) is implementing 8 major changes this year to the Medicare payment systems, according to Becker’s ASC Review (2019). A majority of these changes come from the organization’s 2020 Medicare Hospital Outpatient Prospective Payment System and ASC Payment System Final Rule (CMS, 2019). Other changes were due to the finalization of the CY 2020 Medicare Physician Fee Schedule Final Rule (CMS, 2019).

Read More
Appropriate Use Criteria

Changes to Appropriate Use Criteria for Advanced Diagnostic Imaging

By Vanessa Youmans / February 5, 2020 / 0 Comments

Starting January 1, CMS began testing the condition for Appropriate Use Criteria (AUC) requiring a qualified Clinical Decision Support Mechanism (CDSM) consultation by a qualified provider for payment on Advanced Diagnostic Imaging for Medicare beneficiaries. Claims must include the ordering professional’s NPI, which CDSM tool was utilized for the consultation, and “whether the service ordered would or would not adhere to consulted AUC or whether consulted AUC was not applicable to the service ordered” (Medicine Learning Network, 2018). The program will be fully implemented by January 1, 2021.

Read More

YES HIM Consulting, Inc. Largo, Fl.
Office: (727) 531-3839       Fax: (727) 240-4592