Billing – Page 7 – CRN Healthcare Solutions

When Non-Covered and Covered Procedures Are Performed

July 10, 2018August 28, 2018Barbara Cobuzzi, MBA, CPC, CPC-H, CPC-P, CPC-I, CENTC, CPCONo Comments

There are times when a physician will be performing both covered and non-covered procedures at the same operative session. For example, the surgeon may be performing a septoplasty for a deviated septum (J34.2) and nasal obstruction (J34.89), which is … For more, read here: AAPC Blog

Understand Clearing Houses

June 25, 2018August 28, 2018Barbara Cobuzzi, MBA, CPC, CPC-H, CPC-P, CPC-I, CENTC, CPCONo Comments

Clearing houses affect revenue flow through denials. Understanding them and their processes helps you speed your re-submissions. After a claim file is sent to the clearinghouse, an edit report is sent back to the practice, indicating claims and charg… For more, read here: AAPC Blog

Modifiers 52 and 53 vs. 73 and 74

June 13, 2018August 28, 2018Barbara Cobuzzi, MBA, CPC, CPC-H, CPC-P, CPC-I, CENTC, CPCONo Comments

Modifier 52, Reduced Services and Modifier 53, Discontinued Procedure apply to physician services while Modifiers 73 and 74, Discontinued Out-Patient Hospital/Ambulatory Surgery Center (ASC) Procedure Prior to the Administration of Anesthesia and Disc… For more, read here: AAPC Blog

E/M Documentation by Med Students Rules Clarified

June 7, 2018August 28, 2018Barbara Cobuzzi, MBA, CPC, CPC-H, CPC-P, CPC-I, CENTC, CPCONo Comments

The Centers for Medicare & Medicaid Services (CMS) issued a MLN Matters article ( MM10412 Revised) on May 31 with a retroactive effective date of January 1, 2018 clarifying documentation requirements when performed by Medical Students in a teac… For more, read here: AAPC Blog

Audiology Technician Billing

June 4, 2018August 28, 2018Barbara Cobuzzi, MBA, CPC, CPC-H, CPC-P, CPC-I, CENTC, CPCONo Comments

Medicare stipulates precise requirements for billing audiology technicians’ services. As outlined in the Centers for Medicare & Medicaid Services’ (CMS) Transmittal 84 in February 2008, these requirements are distinct from those governing audiolog… For more, read here: AAPC Blog

Coding 3 or 4 Sinuses Using FESS Codes

May 22, 2018August 28, 2018Barbara Cobuzzi, MBA, CPC, CPC-H, CPC-P, CPC-I, CENTC, CPCONo Comments

A lot of people have been asking questions about how to code FESS surgeries with the new combination codes when three or four sinuses are operated on. Sinus and FESS We have been expecting an AMA CPT® Assistant article with guidance this year, but no … For more, read here: AAPC Blog

Denials Management for the Medical Coder

May 14, 2018August 28, 2018Barbara Cobuzzi, MBA, CPC, CPC-H, CPC-P, CPC-I, CENTC, CPCONo Comments

Managing denials is more difficult in 2018 than it was in 2005, 2000, or 1998. Not because practices are necessarily receiving more denials from payers but because unlike the early to mid-2000s and 1990s, we are now posting payments via auto remit pro… For more, read here: AAPC Blog

Blue Cross of Mich. Reverses Decision

April 12, 2018August 28, 2018Barbara Cobuzzi, MBA, CPC, CPC-H, CPC-P, CPC-I, CENTC, CPCONo Comments

Blue Cross Blue Shield (BCBS) of Michigan is delaying their planned non-coverage of hyaluronic acid injections for knees, slated for April 1. BCBS Pulls Up BCBS giving themselves time to study if hyaluronic acid has the true medical benefit that it c… For more, read here: AAPC Blog

OIG: Many Outpatient PT Claims Fail to Comply

April 5, 2018August 28, 2018Barbara Cobuzzi, MBA, CPC, CPC-H, CPC-P, CPC-I, CENTC, CPCONo Comments

The Office of Inspector General (OIG) did a study of physical therapy claims and documentation for Medicare patients and issued a report this month in March. Their findings are of great concern for the PT and rehabilitation specialty. The OIG reviewed… For more, read here: AAPC Blog

Post-Operative Complications in the Global Period

March 1, 2018August 28, 2018Barbara Cobuzzi, MBA, CPC, CPC-H, CPC-P, CPC-I, CENTC, CPCONo Comments

Is the caring for, and treatment of post-operative complications in the global period coded and billable? To answer this question, You first must know who the third-party payer is because different payers have different rules. What’s the Globa… For more, read here: AAPC Blog