The 2010 ICD-10 Codebook is available in all Regulatory and Coding Suite products.   This is a breakdown of over 2000 pages of coding, mapping, and guidance information reformatted into an easy to search and browse book.  As always, the 2009 archive version has been saved in the Archives libraries - available with other codebook archives in the  Audit & Revenue Resource Center an Regulation & Reimbursement Suite.  If you create bookmarks in the 2009 book, they should now autom

Are you participating in this important program?  We've updated Code Explorer in Coding & Revenue Resource Center and Audit & Revenue Resource Center to make flagging PQRI codes a breeze.   The 2010 Specifications Manual contains details for each specific measure - simply click the GUIDANCE link from Code Explorer to see which measures any particular code falls into and tunnel in for details.  Access the 2010 PQRI&nbsp

The micro lab has numerous “add on” procedures that are routinely performed to complete the culture report. Frequently, add on charges are never captured. There are several reasons for this – some process driven (such as bill drop dates coming too soon for the completion of all testing) and human errors (not submitting charges in a timely manner). One BIG reason is simply because bacteria do not grow at the whim of human time lines.

CMS issues its changes to the Physician Fee Schedule quarterly, but how often do you have the chance to analyze it and review it? With over 15000 lines filling a spreadsheet, comparing each quarter’s changes can be a daunting and time consuming task. Are you aware that MediRegs does this for you? They issue a difference report every quarter that highlights the changes between the current version and the last quarter’s version. Look for the file called “Difference Report” and “MediRegs created.”

A conversation was recently had with a CMS representative regarding their policy and billing instructions associated with observation hours and services in situations when a patient is admitted as an inpatient but is subsequently found to be only eligible for observation; thus billed as an outpatient on the UB-04 reporting the Condition code 44.

Coding professionals face increasing challenges to code claims accurately. Facilities can help ensure documentation integrity and coding accuracy by establishing and managing an effective query process. The importance of complete documentation in the patient’s health record cannot be overstated; without such documentation accurate coding cannot be assigned.

While attending the AMA Symposium this week there was a HUGE uproar about eliminating payments for consults.  I thought one physician was going to take the head off of the guy from CMS!  Whoa baby, talk about hot!  Then you have the coders who are gunning for bear.  The AMA left the CPT consult codes in for 2010 but CMS says they won’t pay!  In light of this, the attending physicians are going to have to bill the initial hospital care day with a modifier.  Then the consultants come along and they have to use the

Fall is here, and along with the change in the weather comes the annual change to CPT codes.

Evaluation and Management: The E/M Guidelines at the beginning of the Evaluation and Management chapter were updated to expand the definition of Concurrent Care to include "Transfer of Care." The new definition reminds users to not use consultation codes when a transfer of care occurs, unless such transfer happens after the initial consultation evaluation.

In part 1 of this modifier series we identified and discussed the largest category—Global Package Modifiers, and the following modifier categories: GP, BUN, E/M only, #, Anes, Lab, and OTH. In part 2, we will explore the other categories of modifiers starting with the “BUN” grouping. 

The following are the modifiers that relate to the bundling of CPT codes or related CCI edits:

In a previous blog I wrote, "Seeing the “Gray” in Evaluation and Management Coding – Chief Complaint and History of Present Illness," I had started a dialogue related to Chief Complaint (CC) and History of Present Illness (HPI) gray areas. In this edition I hope to continue the conversation as it relates to review of systems (ROS) and past family social history (PFSH).