We have trouble billing multiple units of injections and infusions—mostly CPT add-on codes 96375 (injection, each additional sequential intravenous push of a new substance/drug) and 96376 (injection, each additional sequential intravenous push of the same substance/drug provided in a facility)—that are done during observation stays and exceed the medically unlikely edits number. What is the correct way to bill these and get paid?
Accurate clinical documentation is the bedrock of the legal medical record, billing, and coding. It is also the most complex and vulnerable part of the revenue cycle.
I've noticed some conflicting information in CPT Assistant and NCCI edits for CPT code 29874 (knee arthroscopy with removal of loose/foreign body). Do the NCCI edits override the advice in CPT Assistant?
CMS has released the final 2018 ICD-10-CM codes to be implemented October 1, with hundreds of changes from the version released in the 2018 IPPS proposed rule.
When CMS introduced Hierarchical Condition Categories (HCC) with risk-adjusted scores, Ochsner Health System began efforts to educate providers and improve documentation across its many facilities.
Ochsner Clinic Foundation began its ambulatory clinical documentation excellence journey in 2004, when Medicare implemented its Hierarchical Condition Categories (HCC). Since HCCs affect patients’ Risk Adjustment Factor scores, and ultimately reimbursement for the care required to treat sicker patients, Ochsner needed to determine the best way to ensure annual HCC capture for all patients across its vast system.
