A compliance officer is responsible for providing leadership for a healthcare organization's compliance program, but this is not a job a compliance officer must do alone.
Betty B. Bibbins has a message for any healthcare professional-including HIM managers and directors-who struggles to get physicians to document with enough specificity to produce compliant coding and billing: It's your job to tell them how to do it better.
If your utilization review (UR) committee is like many others nationwide, it may not have actually met in years-and chances are your UR committee members are secretly glad that's the case. Let's face it; those meetings can be a complete snooze.
A surgeon performs a diagnostic shoulder arthroscopy before repairing a patient’s rotator cuff. The surgeon knew ahead of time that he or she would be repairing the rotator cuff. Should a coder or biller append modifier -59 (distinct procedural service) to the CPT® code for the diagnostic shoulder arthroscopy to ensure reimbursement for both procedures?
Coding for physician services doesn’t always match coding for facility services, which can cause problems for coders who code records for both. ED E/M is one area where different rules come into play.
