An inflammatory condition that affects the lung tissue, pneumonia can be caused by bacterial infections, inhalation of irritating chemicals, inhalation of stomach contents, or infections by uncommon organisms. Pneumonia can be community-acquired (CAP), health...
Key Issues in Medical Practice Revenue Cycle Management
Success in managing the revenue cycle depends on efficient handling of all the processes from patient enrollment and medical eligibility verification to medical coding and billing and payment collection. Accurate capture of all the information at each stage and proper...
Medical Billing for Behavioral Health Services – Challenges and Solutions
Recent changes to both diagnostic and procedure codes as well as variability in requirements across private and public insurers pose many challenges for behavioral health medical billing: ICD-10-CM includes combination codes for some conditions and associated...
Physician Practice Setting can Improve Reimbursement for Respiratory Therapists
Pulmonary rehabilitation is a multidisciplinary program meant for patients with chronic respiratory conditions, especially for those with chronic obstructive pulmonary disease (COPD). Physicians generally refer patients with moderate to severe COPD to a rehab program...
Coding Post-operative Complications with ICD-10
Postoperative complications can be general or specific to the particular surgery. They are an important cause of morbidity, mortality, extended hospital stay and increased costs. Some examples of postoperative complications are wound infections, coronary artery bypass...
Medical Specialties with Complex Coding Challenges under ICD-10
Now that ICD-10-CM implementation is well on its way, it is evident as to how various specialties have been affected by the changes. Providers can ensure appropriate reimbursement only by documenting diagnoses in sufficient detail or a higher level of specificity to...
Coding ‘Episode of Care’ – The 7th Character in ICD-10-CM
There are several differences between the format of ICD-9 and ICD-10 coding and this has brought about new medical billing and coding challenges. One of these is the need to assign the 7th character denoting episode of care to codes in certain categories of ICD-10....
“Pokemon Go” Injuries – Code it with ICD-10
Can a virtual-reality game played on mobile phone really cause physical injuries? Yes, “Pokemon Go” can. The craze for the game is resulting in more and more accidents. Using Google Maps, it creates a world that mirrors the user’s own reality. Gamers use their mobile...
Medical Coding for Glaucoma Under ICD-10-CM – Key Considerations
A common eye condition that can cause permanent blindness, glaucoma is estimated to affect over 3 million Americans. According to the Center for Disease Control and Prevention/National Center for Health Statistics, the condition accounts for over 10 million visits to...
Clarifications on Reporting Non-urgent Services in the Emergency Department
Emergency department (ED) visits identified by CPT code 99285 require three key components: comprehensive history, comprehensive examination, and medical decision making of moderate complexity. However, a large proportion of all emergency department (ED) visits are...