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| Articles by James Smith |
471. MUE Denials? Here's How to Avoid Them
May 06, 2011
You should not ignore medically unlikely edits; and even if you have to do it, do it at your own risk.
Medically unlikely edits often confuse even the most seasoned coders. See to it that you are not letting MUEs play havoc on your practice's coding and reimbursement by keepi...
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472. Flu Vaccine Codes: CMS Introduces Five Q-Codes To Replace 90658
May 05, 2011
For the 2010-2011 influenza season, CMS has introduced five specific HCPCS codes and payment allowances to replace CPT code 90658 for Medicare billing purposes. Although these codes were effective for services on or after October 1 last year, Medicare claims processing system recognized these cod...
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473. 2011 Vaccine Administration: Now Counseling May Be Given By RNS or LPNS
May 05, 2011
This year's vaccine administration with counseling extend to any qualified health care professional
This year there are a lot of changes to flu vaccines and counseling codes. From January 1 this year, immunization codes 90465-90468 went off the air; they have been replaced b...
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474. Tactics to Stay Away From Irrational Denials
May 04, 2011
Sometimes you may be in a situation where you wanted to contest a denial by an insurance company based on irrational payer guidelines. There's no doubt that it may seem like trying to break down a stone wall, however you are not helpless to change the situation to your favor.
As such what...
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475. Annual Visit Codes: Physicians Should Document Certain Elements
May 04, 2011
Want your annual visit claims to be bang on target? You'll have to ensure the physician or physician team must document certain elements before you bill the new annual visit codes.
Documented elements should set up or update the individual's medical and family history, list the individual'...
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476. Tips to Stay Away from Initial Infertility Denials
May 03, 2011
Here are some tips to help you maximize your ethical reimbursement for initial infertility:
You may be persuaded to code for an initial infertility visit as an office visit, but this may not be the case. Often, a woman's primary-care physician will refer her to your ob-gyn. ...
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477. ROS and the Three Levels
May 03, 2011
What is Review of Systems (ROS)?
The Review of Systems (ROS) is a subjective account of a patient's present or past experiences with illnesses and/or injuries affecting any of the 14 applicable organ systems.
You should know the differences between the t...
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478. Don't Use Modifier SA for Medicare Patients
May 02, 2011
The Nurse Practitioner (NP) provides unsupervised services. Following this, I bill the codes under the nurse practitioner's number for supervised visits, I use modifier SA. In such a scenario, would I bill using the rendering or the supervising provider's NPI? Will payers reduce payment for a superv...
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479. Tips for Spot-On Well-Woman Coding
May 02, 2011
In order to report a well-woman exam correctly, you need to be aware of two important concepts: How Medicare and private payers' guidelines differ, and when you should code breast/pelvic exams and Pap smears separately.
Want to know more about well-woman coding? Take a look at thes...
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480. HCPCS Codes 2011: Get the Pay you Deserve for Medicare Drug Screening Tests
April 29, 2011
Many lab coders are confused now, owing to the 2010 code changes and CMS's surprising 2011 reversals. Don't be. Here, we'll show you the way on ways to get all the pay you deserve for Medicare drug screening tests.
Your choice is ruled by complexity
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Author: James Smith
