Denial Rates in the Danger Zone: Coding to Withstand Audits

Denial Rates in the Danger Zone: Coding to Withstand Audits

By Angela Lima BS, CCS, CDIP, CIC, COC, AAPC-Approved Instructor “One-third of US hospitals’ average denial rates are in ‘danger zone,’ survey finds” Did this catch your attention? This recent article in Becker’s reported results of a survey by consulting firm Harmony Healthcare indicating 33% of hospital executives said their average denial rates were more […]

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Q & A with Dr. Z: Stab Phlebectomy Abdomen

Q & A with Dr. Z: Stab Phlebectomy Abdomen

by David Zielske, MD, CIRCC, COC, CCVTC, CCC, CCS, RCC Question: “11 Stab phlebectomies were performed over varicose veins of her abdomen,” Since 37765-37766 are for extremities, would this be unlisted? 37799? Answer: There is no code for treatment of varicose veins by stab phlebectomy anywhere but the lower extremities. We agree with recommendation to […]

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Coding Education for Providers: Creating a Positive Environment

Coding Education for Providers: Creating a Positive Environment

By Victoria Jennings, RHIA, CCS, CPC-A Here is what you specifically need to understand about education: “When an atmosphere encourages learning, learning is inevitable.” (Elizabeth Foss) Well, that sounds very reasonable. But what makes an “atmosphere that encourages learning?” Thinking now of my providers, what will increase their willingness to learn? I have been educating […]

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ICD-10-PCS: Endotracheal Intubation – Two Approaches

ICD-10-PCS: Endotracheal Intubation – Two Approaches

  ICD-10-PCS: Endotracheal Intubation – Two Approaches   This LibmanLightbox™, by nationally recognized coding authority Lynn Kuehn, MS, RHIA, CCS-P, FAHIMA, focuses on ICD-10-PCS approaches for endotracheal tube insertion (intubation).     Short bursts of learning to illuminate current challenges in medical record coding. Shining a light, where and when you need it.   eLearning […]

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When You Absolutely, Positively, Need to Get it Right: Planning Ahead for 2022 Code Updates

When You Absolutely, Positively, Need to Get it Right: Planning Ahead for 2022 Code Updates

by Angela Lima, BS, CCS, CDIP, COC, CIC, AAPC-Approved Instructor Coding is serious stuff. Getting it right means that your organization will survive, the lights will stay on. If you are one of those coders who recognizes their role in ensuring their organization will continue to be financially viable, then you know that getting it […]

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ICD-10-CM: Social Determinants of Health

ICD-10-CM: Social Determinants of Health

  ICD-10-CM: Social Determinants of Health   This LibmanLightbox™, by nationally recognized coding authority Lynn Kuehn, MS, RHIA, CCS-P, FAHIMA, discusses ICD-10-CM and social determinants of health (SDOH) in categories Z55 to Z65.     Short bursts of learning to illuminate current challenges in medical record coding. Shining a light, where and when you need […]

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Bias in Healthcare Algorithms

Bias in Healthcare Algorithms

By Bradley Merrill Thompson and Jason E. Christ, Epstein Becker Green The application of artificial intelligence technologies to health care delivery, coding and population management may profoundly alter the manner in which clinicians and others interact with patients, and seek reimbursement. While on one hand, AI may promote better treatment decisions and streamline coding and […]

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Q & A with Dr. Z: Embolization of Middle Meningeal Artery

Q & A with Dr. Z: Embolization of Middle Meningeal Artery

by David Zielske, MD, CIRCC, COC, CCVTC, CCC, CCS, RCC Question: What is the correct code to bill for the embolization of middle meningeal artery (MMA)? Is it CPT code 61624 or 61626 since the MMA is part of the external carotid artery (ECA)? For this procedure, selective catheter placements and angiograms were done on […]

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HCCs: Audits of Medicare Advantage Plans and a Coder’s Role

HCCs: Audits of Medicare Advantage Plans and a Coder’s Role

by Rose T. Dunn, MBA, RHIA, CPA, FACHE Hitting the headlines recently was the federal audit finding Humana overcharged Medicare nearly $200M. Humana Inc.’s Medicare Advantage health plan for seniors in Florida improperly collected nearly $200 million in 2015 by overstating how sick some patients were. The audit of Humana occurred from February 2017 to […]

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Q&A with Dr. Pinson: Coding and CDI: Can Intracranial Hemorrhage Cause Acute Blood Loss Anemia?

Q&A with Dr. Pinson: Coding and CDI: Can Intracranial Hemorrhage Cause Acute Blood Loss Anemia?

by Richard D. Pinson, MD, FACP, CCS Q: Can patients with intracranial bleeding from such things as intracerebral hemorrhage, subdural hematoma and subarachnoid hemorrhage develop acute blood loss anemia? Or, do you think it’s mostly hemodilution, especially if fluids are given including hypertonic saline? A: One really can’t lose enough blood inside the confined space […]

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HIPAA and Information Blocking: Part 5: Interference and Exceptions

(posts in this series: part 1, part 2, part 3, part 4, part 5) There are eight exceptions to the Information Blocking Provisions. Do you know what they are?  Join Kelly McLendon, RHIA, CHPS, Managing Director of CompliancePro Solutions, for this fifth in his series explaining what you need to know.   eLearning Library Subscription Unlimited […]

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Responding to Law Enforcement Demands for HIPAA Protected Information

Responding to Law Enforcement Demands for HIPAA Protected Information

by Clay Lee, Associate, Epstein Becker Green Medical providers are often asked, or feel obligated, to disclose confidential information about patients. This blog post discusses when disclosures of confidential medical information involve law enforcement, but the general principles discussed herein are instructive in any scenario. To protect patient confidentiality and avoid costly civil liability arising […]

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