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Billing/Coding

Revenue Cycle Management in Physician Practice Improves with Staff Communication, Training

From the College  |  November 17, 2015

One month has passed since the U.S. healthcare system overcame a historical milestone with the conversion from billing ICD-9-CM to ICD-10-CM. Although the transition to ICD-10 had a major impact on coding operations, its far-reaching tentacles go beyond coding alone and are deeply rooted in the entire revenue cycle. There is room to criticize the…

Rheumatology Coding Corner Answer: Proper Coding for Post-Traumatic Osteoarthritis

From the College  |  November 17, 2015

CPT: 99213, 73500-RT, 73500-LT ICD-10: M16.52 This E/M service entailed: The history is detailed; The examination is expanded problem focused; and The medical decision making is of low complexity. The X-ray reviewed was for radiologic examination, hip, unilateral: one view for the left hip and for the right hip. M16.52—The diagnosis identifies unilateral post-traumatic osteoarthritis…

Rheumatology Coding Corner Question: Coding for Post-Traumatic Osteoarthritis

From the College  |  November 17, 2015

Post-Traumatic OA A 70-year-old female patient comes in for a follow-up visit for pain and stiffness in her left hip. She injured her hip in a skiing accident three years before and reports the X-rays at that time showed no fractures. Due to no obvious fracture at the time, she was given ibuprofen and advised…

Use of Unspecified Codes in ICD-10: What You Need to Know

From the College  |  October 21, 2015

The ACR Practice Management and Coding department will periodically update the membership on the new ICD-10 coding guidelines and conventions to assist practices with accurate billing. Our top question during the first week of ICD-10 implementation was on the use of unspecified codes…

Rheumatology Coding Corner Answer: Coding for a Knee Injection

From the College  |  October 14, 2015

Take the challenge. CPT: 20611-LT, J7325 X 1 ICD-9: 715.16—Osteoarthritis, localized, primary, lower leg ICD-10: M17.12—Unilateral pri- mary osteoarthritis, left knee Note: When billing for 20611—Arthrocentesis, aspiration and/or injection, major joint or bursa (e.g., shoulder, hip, knee, subacromial bursa), with permanent recording and reporting, there must be a permanent photograph of the needle placement in…

Rheumatology Coding Corner Question: Coding for a Knee Injection

From the College  |  October 14, 2015

Coding for a Knee Injection A 68-year-old female patient with primary osteoarthritis of the left knee returns to the office for her scheduled hyaluronan injection. The patient reports that her knee is a little tender, but on a scale of 1–10, it is a 4. She is stiff in the morning for 10–20 minutes. The…

Documentation: A Key Factor of Risk Adjustment

From the College  |  October 14, 2015

In an age of constant change and regulations, one thing remains the same in coding and billing: If it’s not documented, it wasn’t done. This is the main rule for documentation. Good documentation is and always has been the foundation of accurately capturing a provider’s work and the patient’s condition, management and treatment. Introduced by…

Moving to ICD-10 Has Promises, Challenges

Will Boggs, MD  |  September 24, 2015

NEW YORK (Reuters Health)—While the new International Classification of Diseases, Tenth Revision, Clinical Modification (ICD-10-CM) codes offer greater diagnostic precision, their implementation will require training of clinicians, coders, and other staff to minimize payment denials or delays from both public and private payers. Brian Outland and colleagues from the American College of Physicians in Washington,…

Preparing for the Transition to ICD-10

From the College  |  September 15, 2015

The transition to ICD-10 is not just another yearly diagnosis codes update; it is a complete overhaul. This not only will affect providers, but also all payers, vendors and stakeholders are being affected by the expanded ICD-10 code sets through medical coding operations, software systems, reporting, administration, registration and more. With approximately 20 days before…

One-Year Transition Period May Ease the Pain of ICD-10

Kimberly Retzlaff  |  August 25, 2015

As the Oct. 1 deadline to transition to ICD-10 approaches, the CMS has released multiple resources, including a joint guidance statement with the AMA that details one year of claims leniency to help physicians adjust to the new coding system and smooth the transition process…

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