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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 sequencing the underlying condition first followed by the manifestation. 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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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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Ten Steps to Coding Anesthesia Services

WEBAssign the appropriate modifier to identify the anesthesia provider. 10 Steps (cont.) 6. Assign the appropriate modifier to identify MAC services, when appropriate. 7. Assign …

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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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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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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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The Basics of HIPAA Privacy and Security and HITECH

WEB4 Covered Entities • A covered entity is a –healthcare provider, –a health plan, –healthcare clearing house …..who transmits any health information in electronic form 7 Covered …

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Top 50 Codes Behavioral Health

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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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Evaluation and Management Coding for Emergency …

WEBHistory of Present Illness. HPI flushes out the chief complaint in grea t er d e t a il. There are two types of HPI identified for the purpose of coding. A brief HPI consists of 1-3 …

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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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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

WEBHawaii Pacific Health, 490 F. Supp. 2d 1062 (D. Hawaii 2007) In a physician directed clinic setting, any one of multiple physicians who are available in the office suite may be …

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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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Legal Issues in Coding

WEBAAPC Webinar –2011 Legal Issues In Coding 5/20/2011 5 9 Coders Liable? • Actual language of the statute… § 3729. False claims (a) Liability for certain acts.

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2021 E/M Oﬃce or Other Outpatient (99202-99215) Audit …

WEBA clinical laboratory panel (e.g., basic metabolic panel [80047]) is a single test. The differentiation between single or multiple unique tests is defined in accordance with the …

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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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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 …

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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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