Key Role of Coder in Denial Management

Coders are the backbone of an organization’s fiscal health. Timely coding contributes to timely hospital revenue and cash flow, both of which are essential for a hospital to function. However, coders must be willing to look beyond their traditional roles and examine how they can help ensure the continued financial viability and financial success of […]

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Who does the Coding for Physician Services?

The stakes are high. Coding drives revenue.  Coding compliantly is demanded of all practices. Physician compensation is often determined by the RVUs associated with the CPT code that is submitted on the claim form. Health systems and hospitals want to ensure that services submitted under the group NPI are accurate and represent what was done […]

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Benefits of Medical Coding Audits for Oncology Practice

Accurate medical coding plays an essential role in healthcare information management and overall quality of care. Medical coding audits, both internal and external, ensure that healthcare organizations have the proper policies and procedures in place to achieve quality medical coding. Regular audits can reveal inaccuracy issues, such as outdated codes or even fraudulent billing. These […]

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ICD-10 Codes – Type 1 Diabetes Mellitus

Diabetes means your blood glucose or blood sugar is too high. With type 1 diabetes, your pancreas does not make insulin. Insulin is a hormone that helps glucose get into your cells to give them energy. Without insulin, too much glucose stays in your blood. Over time, high blood glucose can lead to serious problems […]

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Basic Coding Guidelines for MNT

Medical nutrition therapy (MNT) is a key component of diabetes education and management. MNT is defined as a ‘nutrition-based treatment provided by a registered dietitian nutritionist.’ It includes ‘a nutrition diagnosis as well as therapeutic and counseling services to help manage diabetes.’ MNT Is an intensive, focused, and comprehensive nutrition therapy service which involves in-depth […]

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Coding Diabetes Mellitus in ICD-10-CM

Results of a recent coding and clinical documentation pilot study indicate that the ICD-10-CM coding classification changes made for diabetes mellitus have significantly improved coding for this disease. The results of the study noted that although a few ICD-10-CM “unspecified” diabetes codes were assigned, the majority of the diabetes codes sufficiently captured the diagnoses as […]

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Basic Guidelines for Accurate Diagnosis Coding

Medical coding facilitates the billing process by bringing uniformity to the procedures through recognizable codes. Using standard diagnosis codes and procedure codes that are recognized by insurance companies, all medical practices, and relevant care related agencies, the medical coder will ensure that the insurance companies, commercial payer, or the Centers for Medicare and Medicaid (CMS) […]

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ICD-10-CM Guidelines for Coding and Reporting FY 2020 – Obstetrics

The Centers for Medicare and Medicaid Services (CMS) and the National Center for Health Statistics (NCHS), two departments within the U.S. Federal Government’s Department of Health and Human Services (DHHS) provide the guidelines for coding and reporting using the International Classification of Diseases, 10th Revision, Clinical Modification (ICD-10-CM). These guidelines should be used as a […]

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ICD-10-CM Guidelines for Coding and Reporting FY 2020 – Respiratory System

The Centers for Medicare and Medicaid Services (CMS) and the National Center for Health Statistics (NCHS), two departments within the U.S. Federal Government’s Department of Health and Human Services (DHHS) provide the guidelines for coding and reporting using the International Classification of Diseases, 10th Revision, Clinical Modification (ICD-10-CM). These guidelines should be used as a […]

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Modifier 50 Fact Sheet

Modifier 50 applies to bilateral procedures performed on both sides of the body during the same operative session. When a procedure is identified by the terminology as bilateral or unilateral, the 50 modifiers are not reported. If a procedure is authorized for the 150 percent payment adjustment for bilateral procedures (payment policy indicator 1), the […]

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