ICD-10 Coding Tips
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).
The World Health Organization (WHO) declared the 2019 Novel Coronavirus (COVID-19) disease outbreak a public health emergency of international concern on January 30, 2020 (CDC, 2020). As a result of the public health emergency, the document, “Announcement New ICD-10-CM Code 2019 Novel Coronavirus (COVID-19),” was released to provide guidance on coding this virus.
Physician group acquisition by major health systems remains a common trend in the industry. One survey of over 8,700 physicians indicates that only 31% of physicians surveyed identify as an independent practice owner or partner as of 2018. This is down from 48.5% in 2012, a whopping 35% decrease in independently owned practices in only 6 years (Merritt Hawkins, 2018). In these acquisitions, the question remains: Who will manage the physician group?
As a follow-up to our previous articles “The HCC Coding Specialist: Benefiting payers, providers, and patients” and “HCC Medicare Advantage background and overview,” we now review HCC chronic conditions and the M.E.A.T. documentation criteria.
The World Health Organization released the 11th edition of the International Classification of Diseases (ICD). This release was presented at the World Health Assembly on May 25, 2019 for adoption by member states, and will come into effect on January 1, 2022. However, note that it is still unknown when ICD-11 will be ready for implementation in the United States.
As we turn the calendar to a new decade, the 2020 CPT code changes take effect. This year there are a total of 394 changes to CPT, bringing the total number of codes to 10,471. This includes 248 new codes, 71 deletions, and 75 code revisions, according to the American Medical Association (AMA). This is Part 1 of a 2-Part Series. In this article, we will discuss the changes in the Surgery Section.
Medical billing denials generate significant cost for providers and hospitals that could be avoided by improving claims data management and optimizing medical coding processes. Optimal quality coding effectively prevents medical claims denials by reducing the potential for manual error and addressing concerns over fast approaching time limits.
Revenue Cycle Management can be thought of as the method of transportation to take an organization from one place to where it needs to go. For the transport to occur successfully and be operationally sound, the processes in place to support it must be accurate and deliberate.
Make Room for Exceptions: This years’ updates to the ICD-10-PCS Official Guidelines for Coding and Reporting include a new section, updates to an existing section, new guidance on a body part, some editorial changes and the introduction to the possibility of exceptions for special cases.