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ICD-10-CM Overview and Coding Guidelines

• Codes that have both an underlying etiology and multiple body system manifestations due to the underlying etiology require … See more

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Health Maintenance Exams: What's covered and What is …

Webcan you bill seperately for 81002 and 82270 with a preventative CPT? what about with a medicare patient? Any test that is considered part of the health maintenance

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The Basics of Outpatient Claims and OPPS

WebProvider, Physician and Supplier Defined. Provider - A clinic, rehabilitation agency, or public health agency including: hospitals, skilled nursing facilities (SNFs), home health …

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Understanding RVU’s and How to Effectively Use Them In …

WebThe Department of Physician Payment Policy and Systems American Medical Association 515 N. State Street, Chicago, IL 60654 Phone: (312) 464-4736 Fax: (312) 464-5849 …

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Breakout Session 2B Telling a Better Story: Making the Case …

Web3/24/2014 1 Breakout Session 2B Telling a Better Story: Making the Case for Ethical Coding Brad Hart, MBA, MS, CMPE, CPC, COBGC President, Reproductive Medicine …

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Billing Incident-to Services

WebNon-Institutional Requirement. 8. •Incident to a physician’s professional services means that the services or supplies are furnished as an integral, although incidental, part of the …

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Understanding Insurance Models For Risk Adjustment

WebPayment of a fixed amount of money that is paid in advance, usually on a monthly rate, to the MCO to cover the delivery of all care and health services. PMPM = per member, per …

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Eliminating Infusion Confusion

WebIV Infusion – a continuous introduction of a solution intravenously (same for IA Infusion only administered intra-arterially) IV Push - also known as a Bolus, is the administration of a …

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Table your Confusion in Coding

WebDysplasia is the earliest form of pre‐cancerous lesion recognizable in a biopsy by a pathologist. Dysplasia can be low grade or high grade (see CIS below). The risk of …

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“Prompt Pay” Statutes And Regulations

Web1 “Prompt Pay” Statutes And Regulations State Status/Terms of Law State Contact Website Address (If Available) Alabama Clean claims paid within 45

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Concepts in Wound Care

Web6 Debridement (11042-11047) Removal by a physician or non-physician provider (NPP) Excision into the viable tissue Excision of the wound edge or removal of necrotic/

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Coding and Billing Pediatric Services

WebSports/Camp Physicals. AAP recommends use preventive medicine codes 99381-99397. If not covered due to previous preventive visit in same year, will be billed to parent. Office …

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Coding for Obstetrics and Gynecology

WebFound on either side of the uterus, below and behind the fallopian tubes. Anchored to the uterus below the fallopian tubes via the ligament of ovary and suspensory ligaments. …

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5E-Medical Necessity

WebMedicare, for example, defines medically necessary as: “Services or supplies that are needed for the diagnosis or treatment of your medical condition and meet accepted …

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5I-Sample Auditing Compliance Plan

WebA committee for processing of external reviews will consist of employees in the organization to identify the requests, copying of medical records, deadlines for submission of requests …

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Ten Steps to Coding Anesthesia Services

WebPerform pre-anesthetic exam and evaluation 2. Prescribe the anesthesia plan 3. Personally participate in the most demanding procedures in the anesthesia plan 4. Ensures …

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Mid-Level Provider Billing

WebMID-LEVELPROVIDERBILLING. Presented by: Amy E. Bishard, BA, CPC, CPMA, CEMC, RCC. OBJECTIVES. Describe scopes of practice for Nurse Practitioners and Physician …

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Evaluation and Management (E/M) Training

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Compliance Programs for Physician Practices

WebCompliance should be part of the culture. Leadership by governing body, physician management. Integrate compliance with operating systems. Focus on core processes …

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