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Feds signal a PHE cease. Expect some waivers, like Stark Law, to go when it does.

04/18/2022

Signs are emerging that the national public health emergency (PHE) related to COVID-19 is entering an end phase, and practices should start planning for a halt to some of their PHE-based flexibilities, such as referral arrangements, that likely are not going to survive it.

Coders should take charge when checking a sales rep’s advice

04/18/2022

by: Julia Kyles, CPC

Remind your providers that coders should fact-check a sales representative’s coding advice before the practice purchases a new product or device.

Unreliable ‘source’? Try others, and document the disagreement

04/18/2022

by: Roy Edroso

Question: One of our providers had an office visit with a cognitively impaired patient and her adult daughter, whom he considers the “historian” in the encounter for E/M level selection purposes. However, the provider suspects the daughter’s version of events may be incorrect. What should he do? And can the daughter’s testimony still be used to calculate E/M levels?

Unpack ICD-10-CM coding for open wounds and superficial injuries

04/18/2022

by: Sarah Gould

From common injuries to burns and poisonings, your coding staff must be familiar with Chapter 19 of the ICD-10-CM manual to ensure coding compliance. Review integumentary anatomy and ICD-10-CM coding for burns and other external injuries to accurately capture your patients’ conditions.

Information please: Follow 6 tips for independent historians

04/18/2022

by: Julia Kyles, CPC

You can use information a provider receives from family members and caretakers to calculate the amount and/or complexity of data to be reviewed and analyzed of an E/M office visit that is coded based on medical decision-making (MDM). But make sure practitioners and coders know how to capture the data element.

Practices keep X modifiers over 6M threshold, beating 59’s denial rates

04/18/2022

by: Roy Edroso

While use of modifier 59 (Distinct procedural service) dropped during the first COVID year of 2020, practices reported the four X modifiers that can be used in place of 59 at a similar clip as in 2019, and denials stayed comparatively lower.

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