The Coding Institute Experts Say - Make Best Use of Extended ICD-10 Training Time

Despite the delay in implementation, experts warn that practices must continue their efforts to prepare for ICD-10 use.

According to a study by Aloft Group in March 2014, nearly half of healthcare providers in the US have completed only 25 percent or less of their ICD-10 implementation plans.  The ICD-10 delay – therefore – is welcome news to many providers.

Providers should view the ‘delay time’ as practice time for detailed documentation – an opportunity to boost new skills. “Of note, we should not throw away the chance to improve the physician’s clinical documentation just because the code set implementation has been delayed,” says Barbara Cobuzzi,  MBA, CPC, CENTC, CPCH, CPC-P, CPC-I, CHCC, president of CRN Healthcare Solutions, a consulting firm in Tinton Falls, N.J.. “It is always a goal to improve clinical documentation,” Cobuzzi adds.

To make the best use of the extended training time, providers should stay focused and take these steps:

·         Maintain the momentum towards ICD-10 readiness

·         Keep tabs on the most frequently-reported ICD-9 codes

·         Devise a top-25 list that will help guide you to the most relevant chapters in the ICD-10 coding manual

·         Focus only on the codes you are most likely to use – All the codes don’t apply to every specialty.

·         Boost your documentation skills – particularly in your focus areas so that by next year, your records will regularly include the kind of detail coders will need.

·         Become familiar with the new coding concepts.

·         Know all of your “points of contact” for ICD-10

·         Ensure practice management/EHR systems can handle the transition.

Providers should also take advantage of various training resources available from AHIMA, CMS, The Coding Institute and other organizations.

Training should be specifically targeted to the conditions physicians handle on a daily basis. The Coding Institute (TCI) offers various ICD-10 training resources through its website, where providers can access ICD-10 charts, newsletter, crosswalks based on general equivalency mappings, and other tools. Last week, the company launched ICD-10 Multispecialty Guide - a Quick-Reference Guide for 23 specialties - to help medical practices in jumpstarting their conversion to ICD-10.

Hospital Billing 2014: CMS Instructions on When Part B Inpatient Billing Applies

Part B inpatient billing is not always top of mind for hospital coders, however the Federal Register outlining IPPS polices for 2014 has addressed this topic. Here are some dos and don’ts of Part B Billing.

When Does Part B Billing Apply in a Hospital Setting?

Part B billing applies in a hospital setting when an inpatient admission is judged as “not medically necessary” after the patient has been discharged. If the inpatient admission is determined as not appropriate, while the patient is still in the hospital, then Condition Code 44 is used and the billing changes to Part B outpatient. Again you cannot bill for observation because a physician has to order observation and this would take place right at the end of the hospital stay.

Watch your steps: In two occasions a determination can be made for the inappropriateness of an inpatient admission after the fact: Firstly when Federal or RAC audit determines inappropriateness and secondly when the hospital, through a self-audit process, determines inappropriateness.

For more information on coding under Condition 44 circumstances, refer to this article featured in Inpatient Facility Coding and Compliance Alert.

Timely Filing – Your First Barrier

For Part B billing, it must be done within the timely filing guidelines for the inpatient admission. i.e, one year from the initial claim. However, a RAC audit may be conducted after one/two/three years after the inpatient services. If the RAC determination holds up and the inpatient admission is determined not medically necessary, then there’s no option in Part B inpatient billing if you are not inside the timely filing guidelines. Therefore, the main time this billing procedure will be used is when the hospital determines the inpatient admission as medically necessary, through self-audit.

Part A Should be Billed First

Not sure how to generate claims for the Part B billing? The Centers for Medicare and Medicaid Services (CMS) instructs you to file a Part A claim on a ‘No Pay/Provider Liable’ basis. Once the Part A claim denials reach your system, you can go ahead with the Part B inpatient claim.

                                                                                              

Don’t Bill Part B if Services are Inherently Outpatient

CMS instructs you to file Part B inpatient claims for services that are not inherently outpatient. As such, you cannot bill observation of services through this process. 

Cardiology-Specific CPT code Lookup to Assist Correct Coding, Reimbursement, & Compliance

Code Search & Expert Advice Customized for Your Practice

CMS has posted the 2013 Medicare Physician Fee Schedule and an element getting a lot of attention from cardiologists is the Multiple Procedure Payment Reduction (MPPR). For cardiovascular services, full payment is made for the TC service with the highest payment under the MPFS. The payment is made at 75 percent for subsequent TC services furnished by the same physician (or by multiple physicians in the same group practice, i.e., same Group National Provider Identifier (NPI)) to the same patient on the same day.
This year’s final rule cuts payments for important cardiovascular services at a time when many cardiology practices are already vulnerable. The MPFS reveals that CMS received plenty of comments about the MPPR rule. The list of affected cardiovascular codes is several pages long, including services such as cardiac and vascular imaging, ECGs, device evaluations, echo, and Doppler. 

According to experts, this is the time to ensure you aren’t writing off potential income and not setting your cardiology practice up for serious scrutiny and unpleasant payback requests. Now you can simplify your task with SuperCoder’sCardiology Coder. You can ensure error-free coding- thanks to online code look-up, coding tools and expert advice from The Coding Institute’s Cardiology CodingAlert.

This online specialty Coder brings you leading-edge cardiology coding guidance as well as tried-and-true tactics to ensure you report correct and updated codes every time to capture your hard-earned payment. 2013  CPT® codes cardiology updates are now also live on Cardiology Coder! This helps in  CPTcode look-up  for cardiology code changes through code search along with expert advice from The Coding Institute. You can also keep your 2012 info into 2013 with 2012 Fee Schedules side-by-side your 2013 rates.

This exclusive resource helps you to garner your deserved reimbursement.

About Supercoder.com:  Supercoder.com has emerged as a robust online platform, providing user-friendly on-line code look-up and expert advice from industry veterans to enable medical practitioners to code effectively.

Give your policy the definitive guidance of AMA

For CPT 2013, the Respiratory System section of the CPT code set contains revised thoracentesis codes, new percutaneous catheter and chest tube codes, and clarification of the open surgical chest tube placement code to better explain the procedural approaches. Similarly, if you code for burn-related services, you know the Rule of Nines is even more complicated than it sounds. You need pinpointed documentation details that will lead you straight to the proper code and clear-cut comparisons of debridement and escharotomy that will take your understanding of this difficult coding area to the next level.

This year there will be immense coding and billing changes that will potentially affect your practice. You need a reliable resource to take care of all your coding and billing needs. Having a comprehensive resource to guide you through all the changes not only helps to file clean claims but also stay profitable. SuperCoder.com’s Code Connect featuring CPT Assistant has incorporated the documentation details and examples to help you understand the implication of each code and its correct use to keep your practice on track!

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Reduce denials and experience a consistent rise in your payments with benefits like CPT Assistant 2012 & 1990-2011 Archives help to save time and increase efficiency, monthly updates on hot topics featured in the just released issue of CPT Assistant and a better understanding of codes to file cleaner claims. Get uninterrupted solutions to any CPT coding question!

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Code Connect from SuperCoder offers definitive guidance from AMA so that you can improve your accuracy and overturn denials and keep your practice compliant and profitable.