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No new conversion factor and PQRS requirements addressed in proposed fee schedule

August 21, 2014 - By DecisionHealth Staff
Payments set until AprilThe "doc fix" implemented April 1 had a 0% update through March 31, 2015, leaving the conversion factor at $35.8228.CMS didn't include a new conversion factor in the proposed fee schedule, saying that it will submit an estimate of the sustainable growth rate (SGR) and convers... Read More

Watch for new bundles for imaging

August 21, 2014 - By Laura Evans
On the imaging front, your spinal mylography procedures (72240-72270) are bundled components of CT neck chest and lumbar studies (72125-72133), though the code pairs have a "1" modifier indicator, meaning you can unbundle them with the appropriate modifier when wanted.Fluoroscopy codes 76000&nb... Read More

Case study: How to code hypertensive heart, kidney disease in ICD-10, part 2

August 21, 2014 - By Laura Evans
Code diabetes based on type, conditionWhen coding diabetes in ICD-10, you will no longer be concerned about whether the patient has controlled or uncontrolled diabetes, as you are in ICD-9. Instead, you'll select from five diabetes categories, explains Deb Grider, CCS-P, CDIP, CPC, CPMA, CPC-H, seni... Read More

New chronic care payments, changes to global periods in proposed fee schedule

August 14, 2014 - By DecisionHealth Staff
Your practice could earn almost $42 per patient every 30 days for chronic care management (CCM) as long as your clinical staff jump through the proper hoops to bill a new G-code, including being available 24/7.The CCM fee and one G-code, GXXX1, were announced in the 609-page proposed 2015 Medicare p... Read More

Watch for new bundles for skin lesion

August 14, 2014 - By Laura Evans
Take care when reporting lesion destruction codes with other skin procedures because the latest quarterly update to the National Correct Coding Initiative (CCI), effective July 1, includes a number of new code pairs involving those codes. For example, destruction of a single premalignant lesion (17... Read More

Case study: How to code hypertensive heart, kidney disease in ICD-10

August 14, 2014 - By Laura Evans
When coding a visit for a patient with multiple chronic conditions, code first the reason for the visit, or, if the physician is addressing more than one problem during the encounter, code the diagnoses in the order listed in the physician's note to demonstrate medical necessity. In general, ho... Read More

2014 coders' salary survey: Primary care coders report new demand for their services, higher pay, part 2

July 17, 2014 - By Laura Evans
Experienced coders are in demand That’s according to the 2014 coders’ salary survey conducted by DecisionHealth, with responses from 300 primary care office staff from around the country. As in past years, this year’s coders’ salary survey received a certain number of respo... Read More

Report whole blood injection into elbow with just one unlisted code

July 17, 2014 - By Laura Evans
Question: One of our physicians performed a whole blood injection, and we're not sure how to correctly code it. He withdrew 3L of whole blood from the left antecubital fossa and then injected the 3mL of whole blood into the right lateral epicondyle to address tenderness and weakness with resisted fi... Read More

ICD-10 Corner: ICD-10 LCDs include high volume of new codes, new specificity requirements

July 17, 2014 - By Roy Edroso and Julia Kyles
Even though the ICD-10 effective date has been pushed back to Oct. 1, 2015, many Medicare administrative contractors (MACs) have given you some powerful tools to transition to the new code set – their coverage policies, including payable I-10 codes. The MACs ultimately may make revisions to t... Read More

2014 coders' salary survey: Primary care coders report new demand for their services, higher pay

July 02, 2014 - By Laura Evans
Pat yourself on the back - primary care coders as a group got a more than 5% raise last year to an average rate of $51,019, compared with $48,467 in 2012. That's according to the 2014 coders' salary survey conducted by DecisionHealth, with responses from 300 primary care office staff from aroun... Read More


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