Medical Billing Blog: Section - Medical Coding
Archive of all Articles in the Medical Coding Section
This is the archive containing links to all articles written in the Medical Coding section of our blog.
Click any of the article links below to read the entire article or browse another section to the right to read articles on another subject.
Hypertension Coding in the Age of Quality
The hypertension “epidemic” hearkens back to boxer Joe Louis’ words regarding a smaller, quicker opponent — light heavyweight Billy Conn, “You can run, but you can’t hide!” No matter what specialty of medicine or surgery you practice, or whether you are a primary-care provider, elevated blood pressure represents a recurring problem that will not go away. Furthermore, hypertension is often accompanied by comorbid conditions such as diabetes mellitus, obesity, CKD-3, and systolic dysfunction which complicates blood pressure treatment, according to researchers at University of Miami Miller School of Medicine. The downside of this epidemic is clear, untreated blood pressure is fraught with multiple target organ complications. In fact, approximately 80 …
Most Providers Report Lack of Health IT Interoperability
A new eHealth Initiative survey found 68 percent of providers believe current interoperability solutions fail to help meet the goals of value-based care. Researchers in 2017 Survey on Access to Patient Information gathered responses from 107 respondents including CEOs and other executive leadership, IT leadership, clinical staff, and administrative leadership from hospitals, health systems, medical groups, physician practices, HIEs, and other organizations. The survey addressed issues including health data exchange, interoperability, federal regulations, patient access to information, and patient engagement. Researchers found that most providers believe technology has improved healthcare quality since 2008, but certain areas—including interoperability—are still in need of significant improvements. “Sixty-three percent agree that technology has helped …
10 Common Physician RCM Mistakes
If you’re familiar with the beloved sitcom “Seinfeld,” then you have probably seen “The Opposite,” an episode where George Costanza takes it upon himself to do the complete opposite of what he believes is right. The episode serves as the inspiration for Craig Pedersons’ presentation, “Physician Compensation: 10 Common Mistakes (and Four Solutions),” at the Medical Group Management Association (MGMA) Annual Conference in Anaheim, Calif. “I am going to go through case studies and specific examples of financial train wrecks. I’m not trying to tell people what to do, I’m telling them what to avoid. Case studies allow examples to become a lot more real,” says Pederson, a principle consultant …
The Cloud Protects Practices from Mother Nature
Late last week, as Irma devastated Florida’s Atlantic and Gulf coasts, I had the opportunity to speak with one of our medical practices in the area. As I shared my concerns and best wishes with them, they quickly reminded me how valuable it is to have their entire practice’s data securely stored in the cloud—far away from the rain, devastating winds, and storm surge. With the destruction left in the wake of hurricanes Irma and Harvey, it is wonderful to know that cloud technology is helping people worry less and avoid further damage. Here are four disasters modern medical practices across the southern U.S. will sidestep in the storm aftermath: …
Is Your EMR User Friendly?
A common complaint about EMRs is that while they might have technical capability, they might not have real world usability, or be “user friendly”. Thus, you might be able to enter A, B and C; but finding the previous values of A, B and C might be challenging, and seeing the history of A, B and C might not be possible. As I sat in front of one of my medical providers recently, who is a late and reluctant convert to EMRs, he created an on paper list of my previous values as he inefficiently hunted through my now online history. And unless he types them back in in a …
EHR companies refuted claims of violating HIPAA
The EHR Association (EHRA) Executive Committee has fired back at accusations that EHR companies are partially to blame for interoperability problems, claiming health data exchange is progressing quickly. The association published a response to an earlier post on Health Affairs Blog that accused EHR and health IT companies of monetizing the custody of patient protected health information (PHI). Former ONC Chief Privacy Officer Lucia Savage urged the Office of Inspector General (OIG) to enforce provisions of HIPAA prohibiting business associates such as EHR developers from using PHI for business operations. She stated some EHR companies may be leveraging ownership of patient PHI for profit. “Building a revenue stream out of …
How to Choose Between Modifiers 25 and 57
When reporting an evaluation and management (E&M) service on the same claim with another service or procedure, you must append either modifier 25 “Significant, separately identifiable evaluation and management service by the same physician or other qualified healthcare professional on the same day of the procedure or other service,” or modifier 57, “Decision for surgery” to the E&M service code. Modifier Identifies Separate Nature of E&M Service A minimal patient evaluation is necessary to determine that a prescribed treatment is appropriate to manage the patient’s condition. For example, if a patient presents for a previously scheduled injection, the provider will briefly evaluate the patient to confirm that the injection remains …
Your Medical Billing Team is The Center of Your Business
Over the past three years, I’ve really managed to shift who makes policies, enforces policies, and understand why policies are made. Often times, leaders and managers who lack either training or experience create more and more policies rather than approaching a specific person about their behavior. Typing up a policy seems the least resistant way to handle a problem. But I warn you this is the worst approach to take. When you create policies for this reason, you are stifling and handcuffing your remaining staff, who will most likely end up leaving the company due to so many rules and policies. Let’s be clear here, I love structure and process, …
You Should Worry about Medical Coding Guidelines Changing
Changes are coming with Evaluation and Management (E&M) coding guidelines. I will use this space to explain why these changes will be both a good thing and a challenge to physicians, particularly those who derive much of their income from office visits. CHANGE IS OVERDUE It has been 20 years since the 1997 E&M guidelines were promulgated. They were confusing to most physicians then and remain confusing today. One study from the Journal of Family Practice showed that physicians are accurate in their E&M coding only 55 percent of the time, yet Mitchell King, MD provided a fascinating follow-up investigation in the Archives of Internal Medicine that showed certified coding …
A New Platform for Educating New Doctors on EHR Use
Over the past few years, the Regenstrief Institute and the Indiana University (IU) School of Medicine began to notice a problem. While EHR technology had become ubiquitous in the healthcare industry, medical school curricula had not evolved to reflect this reality. This realization became the impetus for the Regenstrief Institute’s EHR Clinical Learning Platform. “It didn’t start out as this,” Regenstrief research scientist and Assistant Professor of Clinical Medicine at IU School of Medicine Blaine Takesue told EHRIntelligence.com. “It started from a different project here at IU,” he continued. “We’ve had proprietary EHR for decades and we noticed we didn’t do much in the way of direct instruction through the …
