Healthicity Blog

In November of 2017, I attended the annual AMA CPT and RBRVS 2018 Symposium (Whew! What a mouthful!) in Chicago where I learned a ton about the new and revised codes for this year.

Are you sure that your procedure audits are thorough? Increase audit accuracy and streamline your audit process with procedure checklists.

Modifier 59 is shockingly confusing for coders, auditors and physicians alike. It’s frequently misused, for example, it’s often added as prevention or recoupment of an insurance denial as a way to get additional procedures paid.

For those of you unfamiliar with coding and billing, modifier -59 is a two-digit numeric code modifier that can be appended to a CPT or HCPCS procedure code, for example, and will frequently bypass many payor edits.

“Time is on my side. Yes it is.” But knowing whether or not time is a factor to qualify for a particular level of E/M can lead to uncertainty. So when is time a factor?

The OIG has frequently reviewed chiropractic services over the last several years. Their most recent report was posted on their website on Aug. 18, 2017 and concluded that a Brooklyn chiropractor had a 100% error rate for claims over a two-year period worth about $672,000.

Sometimes, when I mention coding and documenting Transitional Care Management, coders and auditors will get a crazy look in their eye that can best be described as, “subtle fear.”

But don’t panic, it’s easier than you think!

Recently, I talked with Christopher Chandler, a senior consultant at a large medical group in the professional coding and reimbursements department. Christopher explained a whole slew of surgical coding misunderstandings like confusion about how ICD coding works with CPT coding and what to do with...