Shelley C. Safian, PhD, RHIA, CCS-P, COC, CPC-I, unpacks local and national medical necessity standards and best practices for avoiding denials due to inadequate documentation.
Among the proposed changes, many of which affect quality and data reporting programs, are proposed changes to claims data used for rate setting, a delay of the three way split criteria for Medicare Severity Diagnosis-Related Groups (MS-DRG), and more. Understand major proposals and their potential impact and how to provide feedback to CMS.
Certain provider services such as acupuncture and cosmetic surgery are not reimbursed by Medicare. This article describes when and how to apply HCPCS modifiers for non-covered services.
Facilities can limit their exposure to claim denials and external reviews by implementing a robust internal coding compliance program. This article breaks down components of a coding policy and compliance plan and approaches to monitoring coding quality.
Correct coding for mechanical ventilation depends upon a thorough grasp of medical terminology and coding guidelines. Brush up on your knowledge of mechanical ventilation coding to ensure it's done right.
Anxiety disorders are the most common mental illness in the U.S., according to the National Institute of Mental Health Statistics. Shelley Safian, PhD, RHIA, CCS-P, COC, CIC, breaks down ICD-10-CM coding for common types of anxiety disorders and psychotherapy treatments used to manage them.
ICD-10-CM codes for traumatic fractures specify the type of bone injury, affected area of the body, and in some cases, the degree of soft tissue damage. Refresh your knowledge of terminology and documentation requirements to ensure accurate coding.
The 2022 ICD-10-CM manual includes new codes for thrombotic microangiopathy (TMA)—a rare clinical syndrome defined by the presence of hemolytic anemia, organ dysfunction, and low platelets. Read up on TMA pathophysiology and diagnosis coding.
Modifier -58 describes a staged or related procedure or service by the same provider during the postoperative period. Apply these experts tips to ensure it's used correctly.
