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Medical Billing and Coding News

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OSI, a leading medical billing outsourcing company provides you with the latest news on topics that effect the medical industry.​

ICD-10 Coding for 6 Common Respiratory Problems. Diagnosing respiratory conditions can be complex. When it comes to reporting diagnoses, physicians can always rely on experienced medical coding companies. With extensive knowledge of the anatomy of the respiratory system, related coding guidelines, and the latest codes and guidelines, skilled medical coding service providers are well-equipped to handle ICD-10 coding for respiratory diseases. The ICD-10 codes for diseases of the respiratory system are: ICD-10 codes for Common Respiratory Conditions This article discusses the ICD-10 coding guidelines for six common respiratory conditions – sinusitis, pharyngitis, influenza, pneumonia, chronic obstructive pulmonary disease (COPD), and bronchitis. Sinusitis WebMD defines sinusitis as “an inflammation, or swelling, of the tissue lining the sinuses”. The ICD-10 code set for sinusitis is J00-J99 which includes acute, acute recurrent and chronic sinusitis codes for maxillary, frontal, ethmoidal, and sphenoidal and pansinusitis.

Pharyngitis. How to Use CPT Codes for Angiography Procedure. A coronary angiogram or angiography is a common procedure that uses X-ray imaging to see your heart’s blood vessels such as an artery or vein. This test is performed to see if there is any restriction or abnormality in blood flow going to the heart. Typically, most angiographic procedures are performed in extremities or peripheral regions to diagnose any peripheral vascular disease. These procedures require adequate documentation, which is effectively provided by medical coding companies that serve medical professionals.

How Is Coronary Angiography Performed? Coronary angiograms are part of a general group of procedures known as heart (cardiac) catheterizations which can both diagnose and treat heart and blood vessel conditions. Cardiac catheterization is most commonly performed to examine the coronary arteries because heart attack, angina or heart failure most often originates from disease in these arteries. Usually, the procedure of cardiac cath is safe. CPT Codes for Angiography. How to Identify and Apply ICD-10 Combination Codes.

With 363 new codes, 142 deletions, and 226 code revisions made to the ICD-10 code set this FY, diagnostic coding has become even more challenging. As medical coding service providers know, knowing how to use combination codes is a key aspect in reducing the complexity of ICD-10 coding. Importantly, reporting them correctly is necessary to avoid claim denials. Combination codes allow for the reporting of a single code to express multiple aspects of the diagnosis. The ICD-10-CM Official Guidelines for Coding and Reporting describe a combination code as one used to classify the following: Two diagnosesA diagnosis with an associated secondary process (manifestation)A diagnosis with an associated complication In ICD-10, combination codes identify both the definitive diagnosis and common symptoms of that diagnosis.

Combination Codes – ICD-9 versus ICD-10 Technically, this is similar to the way ICD-9 defined combination codes. Points to Note Identifying and Applying Combination Codes. New Diagnostic Codes for Substance Use Disorders and ARFID in 2018. The National Center for Health Statistics (NCHS), the federal agency responsible for the use of the ICD-10 in the United States, recently released an updated version of the ICD-10-CM, the HIPAA-adopted code set for medical diagnoses used by medical providers, insurers, and health care administrators. The 2018 update of the ICD-10-CM came into effect on October 1, 2017, which indicates that the users of the ICD-10-CM are required to start using the updated codes as from that date. Medical billing companies must be up-to-date with coding changes made frequently so that physicians can receive their reimbursement on time. Mental health and/or substance use disorders (SUD) occur when the recurrent use of alcohol and/or drugs causes clinically and functionally significant impairment such as health problems, disability, and failure to meet major responsibilities at work, school, or home.

Diagnostic Code Updates. Emergency Department Coding and Documentation. Emergency medicine has changed rapidly and significantly over the years. Today, the emergency departments (EDs) are diagnosis and treatment hubs for emergency as well as non-critical patients. As the American College of Emergency Physicians (ACEP) notes, much of the evaluation and investigation which was previously performed as an inpatient is now being done routinely in EDs. The increase in the intensity of ED services have amplified the complexity of coding for the various types of emergency department visits.

In addition to being well-versed in reporting existing ED codes, physicians and medical coding companies need to prepare for coding changes effective January 1, 2018. Get Familiar with ICD-10 Codes for Encephalopathy. Urinalysis Medical Billing Guidelines and Procedure Codes. Urinalysis is the analysis of urine for the diagnosis and monitoring of several medical conditions such as urinary tract infections, bleeding in the urinary system, or kidney or liver disease as well as diabetes, some diseases of the blood, and bladder stone. Medical billing and coding companies assist providers in reporting pathology procedures related to analyses of urine specimens in accordance with Medicare, Medicaid, and other federally-funded payer requirements.

Recent reports on the misuse of urine testing for the presence of drugs of abuse have led to increased scrutiny of pain management billing. Providers should take care to order urine lab testing only when it is medically necessary and provides a corresponding benefit to the care and treatment of the patient. Urinalysis CPT Codes Urinalysis methods used by diagnostic laboratories include visual examination, reagent strip screening, refractometry for specific gravity, and microscopic inspection of centrifuged sediment. New CPT Codes for Behavioral Health Services in 2018. Starting January 2017, the Centers for Medicare and Medicaid Services (CMS) approved payment for services provided to patients with behavioral health disorders who are participating in psychiatric collaborative care programs or are receiving behavioral health integration services. Medical coding companies utilized the three CMS approved HCPCS codes – G0502, G0503 and G0504 – for billing these services.

In 2018, new CPT codes replace the 2017 HCPCS codes for Collaborative Care Management-Behavioral Health Integration (CoCM-BHI). The three new CPT codes to report psychiatric collaborative care management (PCCM) in starting January 1, 2018 are: 99492, 99493 and 99494. Reporting CPT Codes 99492-99494 Psychiatric collaborative care management (PCCM) as described by Current Procedural Terminology (CPT) 2018 reflects behavioral health services delivered via a specific evidence-based model. PCCM code Critical Role of Primary Care Clinicians in PCCM. Coding Musculoskeletal Ultrasound Guided Procedures. Safe and noninvasive, ultrasound is being increasingly used in various medical specialties. Ultrasound is considered the appropriate imaging service to diagnose musculoskeletal (MSK) conditions, specifically shoulder pain and certain ankle and tendon pain. Medicare reimbursements for MSK ultrasound studies increased by 316% from 2000-2009.

Experienced medical billing and coding companies help providers take advantage of the increased payments by staying current with the latest appropriate use criteria and reporting guidelines. Reporting MSK Ultrasound Services – Necessary Criteria All ultrasound examinations must: Meet medical necessity requirements as specified payerReported using codes that provide the highest degree of accuracy and completenessBe documented in the patient’s record, regardless of the type of ultrasound equipment that is used CPT Codes for MSK Ultrasound Evaluation Coding for diagnostic MSK ultrasound requires an understanding of CPT codes 76881, 76882 and 76942:

Coding and Reporting Pediatric Preventive Care Services. Changes in Medicaid, the Children’s Health Insurance Program (CHIP) and new rules governing employer-sponsored and marketplace insurance plans have improved access to necessary health care for children and young adults over the years. Preventative care protects children against different types of diseases and infections, and allows physicians to monitor and evaluate their physical and mental well-being as they grow and develop.

As physicians strive to provide proper preventative care, they can rely on outsourced medical billing and coding services for submitting accurate claims to minimize denials and payment delays, and to indicate that well-care was provided so that quality of care goals can be demonstrated through claims data. Private insurance and Medicaid coverage is available for all age- and gender-appropriate Preventive Medicine visits (Wellness Visits) including all routine immunizations. Preventive Medicine Service Codes New Patients Established Patients Points to Note: Learn About Warts - Types, Documentation with ICD-10 Codes. Warts are a form of lesion or skin growth most often caused by the human papillomavirus (HPV). Some warts are bacterial, rather than viral. Dermatology medical billing involves documenting diverse skin disorders including warts. Mainly caused by the excessive and rapid growth of keratin, which is a hard protein on the top layer of the skin, warts come in a wide range of shapes and sizes – a bump with a rough surface, or it may be flat and smooth.

It can occur at any age, but are most common in children, young adults, and people with immune system deficiencies. HPV infection is acquired from direct contact, which may be person-to-person or from the environment. Five major types include Clinical assessment of the lesion involves inspecting the patient to check the number of lesions and location, describing the lesions including color and any secondary changes, and checking the patient’s overall health. ICD-10 codes for warts are – Coding Chronic Obstructive Pulmonary Disease in ICD-10. According to a recent GlobalNewswire press release, prevalence of Chronic Obstructive Pulmonary Disease (COPD) has increased from around 3% to over 11.6% in people over age 65. As a medical billing company receiving a large number of claims related to services provided for this condition, we are well aware of the ICD-10 specificities involved in coding for COPD and asthma.

ICD-10 allows for better capture of the clarification and quantification of the patient’s condition. COPD is characterized by coughing, breathing difficulties, and strong mucous production in the lungs. The patients’ lungs lose their ability to repair damages on their own. Like high blood pressure, COPD, is a “silent killer”. A chronic cough is generally the first sign of COPD and as the disease progresses, the airways narrow and usually leads to pulmonary emphysema.

Asthma is chronic lung disease that causes inflammation in and narrowing of the airways. For COPD and emphysema, ICD-10 offers two base code categories: Most Frequently Used CPT Codes in Psychiatry and Upcoming Changes. Mental health and/or substance use disorders (SUD) affect millions of Americans. According to a 2016 U-M Behavioral Health Workforce Research Center report, nearly 1 in 5 Americans live with a behavioral health condition in a given year. However, there is a workforce shortage of mental health professional across the country. According to the study, there are substantial payment, reimbursement, and billing issues around behavioral health. Ensuring that psychiatrists, clinical psychologists, and licensed clinical social workers receive proper reimbursement for common procedures is critical to enhance access to behavioral health services. Medical billing and coding services allow providers to take advantage of revenue opportunities in behavioral health.

New Codes for Psychiatry Services in 2018 In 2017, the Centers for Medicare and Medicaid Services (CMS) introduced new BHI and Psychiatric Collaborative Care Model (CoCM) codes. CPT codes commonly used by Behavioral Health Providers. New Study shows Significant Link between Dementia and Pressure Ulcers. Pressure ulcers or bed sores occur due to increased and continuous pressure on the skin. They are a common condition affecting older hospitalized patients as they are prone to mobility problems and aging skin. These sores or “pressure injuries” as they are now called, can range from mild reddening of the skin to severe tissue damage and sometimes infection affecting muscle and bone. Skin changes make dementia patients more vulnerable to pressure ulcers The Jerusalem Post recently reported on a new study from Jerusalem’s Herzog Medical Center, which found significant links between two seemingly unrelated conditions — dementia and pressure ulcers.

The researchers found that many patients with Alzheimer’s and other dementias – especially at an advanced stage – are more likely to develop pressure sores. The hypothesis is that dementia causes abnormal changes in the brain, which can also affect other body systems. Reporting pressure ulcers in 2017 – new documentation requirements. Implications of Recent Changes in Bunionectomy Coding. In 2017, podiatry practices and their medical billing and coding companies saw several changes and updates in bunionectomy coding. In addition to new bunion and bunionette ICD-10-CM codes, major changes have been made to some bunion surgery CPT codes to update them depending on current methods of the repairs.

Prelude to the 2017 ICD-10 Bunion Code Additions Before we go into the 2017 diagnostic code changes, let’s see how ICD-10 simplified Bunion Coding from ICD-9. In ICD-9, there were two separate codes for bunions based on the deformity. 727.0, (Synovitis and tenosynovitis) was used for a bunion without the toes overlapping727.1 (Other disorders of synovium, tendon, and bursa; bunion) was used for bunions with hallux valgus, where the toes overlapped ICD-10 introduced specificity and changes the codes for bunions as: M20.10 Hallux valgus (acquired) unspeci¬ed footM20.11 Hallux valgus (acquired), right footM20.12 Hallux valgus (acquired), left foot Bunions (M21.61-) Bunionettes: (M21.62-) Stay Compliant with Accurate Pathology/Lab Diagnostic Coding.

Reporting of pathology procedures and clinical lab tests witnessed several changes starting October 1, 2016. Medical coding outsourcing is widely recognized as a practical strategy to help pathology labs maximize reimbursement, avoid denials, and stay compliant with accurate diagnostic coding. The golden rule in 2017 is to code to the full specificity of services provided. This implies the following: Diagnoses documented as probable, suspected, questionable, rule-out or a working diagnosis should not be coded.

Here are the key ICD-10 coding changes impacting pathology lab reporting in 2017: Malignant Carcinoid Tumors code updates ICD-10 code updates of the site-specific malignant carcinoid tumors in 2017 changed code definitions from ‘NOS’ or ‘not otherwise specified,’ to ‘unspecified’ as follows: C7A.094 – Malignant carcinoid tumor of the foregut, unspecifiedC7A.095 – Malignant carcinoid tumor of the midgut, unspecifiedC7A.096 – Malignant carcinoid tumor of the hindgut, unspecified. Expanding Role of Telemedicine in Diabetes Retinopathy Screening. Billing and Coding Changes that Matter to Anesthesiologists in 2017. CPT codes for Interlaminar Stabilization for Spinal Stenosis.

Examples of CPT, HCPCS and Anesthesia Modifiers. 2017 Coding and Reimbursement Guidelines for Vascular Surgeons. FDA Approves Label Changes for General Anesthetic and Sedation Drugs. Stay Up-to-date with ICD-10 Diagnostic Codes for Hepatitis. 2017 CPT Coding Updates for Pathology and Lab Services. Maximize Cardiology Reimbursement with New CPT Codes in 2017. High-Risk Pregnancy - ICD-10 Coding Changes in 2017. High-Risk Pregnancy - ICD-10 Coding Changes in 2017. Medical Billing and Coding for Telehealth Services in 2017. Challenges of Coding Traditional and Laparoscopic Colorectal Surgery.

New CPT Codes for Dialysis Circuit Interventions in 2017. Medical Billing Services | Outsourcing Company | OSI. Know Ob-Gyn CPT Code Changes in 2017 to Optimize Reimbursement. Choose the Right Medical Codes for Polyp Removal. Critical Care Billing and Coding - Guidelines to Avoid Denials. Implement 2017 CPT Code Updates for Diagnostic Radiology. Billing and Coding Tips for Spine and Pain Management. ER Billing Complaints on the Rise – What Physicians should Watch out for. Documenting Food Allergies with ICD-10 Codes. Pneumonia - Code It Right in ICD-10-CM. ICD-10 Chiropractic Codes to Document Winter Vehicle Accidents.

Detailed Clinical Documentation Crucial for Accurate Abscess Coding. Reporting Back Pain in ICD-10-CM. Common Revenue Cycle Management Challenges and How to Overcome Them - mosoutsource. Get to Know the Strangest ICD-10 Codes. Strategies to Minimize Vaccine Administration Losses. Coding the Dental Examination Visit Correctly. Strategies for Surviving End of ICD-10 Flexibilities by Outsource Strategies. Detailed Clinical Documentation Crucial for Accurate Abscess Coding. Flu Season is Here – Changes in CDC’s Immunization Guidance & Codes. Dental-medical Cross Coding can Increase Dental Practice Reimbursement. Prepare for Payer Audits and Avoid Compliance Issues. 2016 HCPCS Coding Corrections. Medicare Part B Now Covers Really Expensive Drugs. ICD-10-CM - Overview, Significance and Top Diagnostic Codes. CMS Proposes Changes to Two-Midnight Rule for 2016.

ICD-10 Medical Coding for Myocardial Infarctions. Transitional Care Management Services – Coding and Documentation. Importance of HIPAA Compliance Document in Medical Billing. Key ICD-10 Documentation Elements for Major ED Encounters. Improving Physician-CDI Engagement for Smooth Transition to ICD-10 Documentation. Are Healthcare Providers Ready for the Transition to ICD-10? - Seekyt. Physicians Not Yet Ready for the ICD-10 Transition. Gastroesophageal Reflux Disease (GERD) – Diagnosis and Coding. Google Glass for Better EHR Management. CMS Proposed Changes to Home Health Payment System. Getting Reimbursement for Unlisted Procedures. Medicare Overpayment and Measures to Avoid Penalties. Shared Medical Appointments – Pros and Cons.

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Enjoying Summer the Best Possible Way - Safe and Healthy. Prepping Your Medical Website for the New Season. Solutions to Mitigate Rising Dialysis Costs. Rising Physician Burnout Blamed on EHR. Important Considerations When Switching an EHR System. How to Improve Patient Collections | Ensure Success Patient. How Mobile Applications are Changing Healthcare. AMA Releases CPT Codes for Advanced Care Planning Services. How can Medical Billing Companies be more efficient? Understanding HEDIS Better. How ASCs Can Improve their Revenue from Increased Patient Volume. Strategies to Improve Revenue Cycle Management. Most Practices Replacing Their Medical Billing Software. Medical SEO for Hospitals. How to Improve Your Medical Practice. Steps to Select the Right Medical Billing Firm. Tips To Maintain Patient Interaction while Using EHR.

Different Types of Medical Billing Fraud and Abuse. Outsourcing Medical Billing – Pros and Cons. The Significance of Professional Medical Coding Services. The Growing Importance of Professional Medical Coding Services. What to Consider When Developing Content for Your Medical Website. How Online Billing Service Is Beneficial for Medical Practices? Opioids Use among Returning Soldiers Studied.