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AnnexMed is a leading provider of Revenue Cycle Management Services to the Healthcare Industry in the United States.

10Jan

Coding for Pressure Ulcers on the OASIS-C2 Item Set

Pressure ulcers are among the most common conditions that are addressed by home health care workers. Patients with limited mobility — especially those who are bedridden or who use wheelchairs — are often at high risk of developing pressure ulcers, so home healthcare workers are often involved in prevention, identification, management, and/or treatment. As a […]
10Jan

Changes in the ICD-10 CM Code Set for 2018

Last week on the blog, we talked about the new Medicare telehealth services codes that are set to take effect in January. These new codes were added to the CPT and the HCPCS code sets, but these are not the only code sets that are due for an update in 2018. The ICD-10 CM code […]
10Jan

New Medicare Telehealth Services Codes for 2018

As technology reshapes the way people think about the provision of healthcare, telehealth services are on the rise. In order to respond to this trend, the Centers for Medicare and Medicaid Services (CMS) is adding several new codes to the CPT and the HCPCS code sets for calendar year 2018. If your practice provides telehealth […]
10Jan

Complying with New Regulations on Federal Employee Workers’ Comp Claims for Opioid Medications

In light of the growing epidemic of opioid addiction and overdose in the United States, the Division of Federal Employees’ Compensation (DFEC) within the Office of Workers’ Compensation Programs (OWCP) has issued new guidelines for workers’ compensation claims for opioid medications for federal employees. While the OWCP DFEC acknowledges that opioid medications are valuable for […]
10Jan

New K Codes for Continuous Glucose Monitors

In the United States today, an estimated 30.3 million people — about 9.4 percent of the total population — has diabetes. Patients with diabetes have to monitor their blood glucose levels regularly in order to make key health decisions related to diet and insulin dosage. The traditional way for patients with diabetes to test their […]
10Jan

Making Sense of the HCPCS Code Groupings

In last week’s post, we provided an overview of the Healthcare Common Procedure Coding System (HCPCS). This code set is administered by the Centers for Medicare and Medicaid Services (CMS), and is it used primarily to bill government payers (although some private payers also utilize the HCPCS code set). HCPCS Level I is identical to […]
10Jan

The HCPCS Coding System: What You Need to Know

Last week, we looked at the ICD-10 and CPT coding systems, which are the two dominant code sets used for medical coding and billing in the United States today. However, if you’re billing Medicare, Medicaid, or one of a few other third-party insurance payers, you also need to be familiar with the Healthcare Common Procedure […]
10Jan

Working with the ICD-10 and CPT Code Sets

One of the most challenging things about medical coding today is the complexity of the different coding systems. To meet your goals for A/R days and keep your revenue cycle running smoothly, your coding staff needs to be able to quickly and efficiently prepare and submit claims for processing. Every day, medical staff at physicians’ […]
10Jan

Understanding Worker’s Comp Claim Denials and Objections

Every year, an estimated 3.5 percent of full-time employees in the United States make worker’s comp claims to pay for medical treatment for work-related illnesses and injuries. For small clinics that regularly provide care for these patients, problems with worker’s comp claims can quickly lead to major problems. Not only do patients get upset when […]
10Jan

The Basics of Medical Coding for Telehealth Visits

Advanced communication technology is revolutionizing the way healthcare is provided. One of the most significant advances in the last decade is telemedicine, which refers to a broad range of remotely-provided medical services. One such service is telehealth visits, through which physicians provide care for patients in remote offices. This can be especially helpful for patients […]
10Jan

The Pitfalls of Electronic Medical Records: Forgetting to Bill for Minor Procedures

One of the most significant advances in the healthcare field over the last few decades has been the introduction of electronic medical records (EMRs). The range of benefits that have resulted from this technological advance are innumerable. EMRs make it possible for physicians like you to see more patients in less time, and they facilitate […]
10Jan

Ten Years On: A Look at POA Indicators a Decade after Implementation

In order to ensure proper reimbursement, it is essential for inpatient health care facilities to record the medical conditions that the patient has when they are admitted. This information is documented using Present On Admission (POA) indicators. POA indicators differentiate between medical conditions that were present at the time of inpatient admission and those that […]
09Jan

Medical Coding for Sexually Transmitted Diseases

Earlier this week, the U.S. Centers for Disease Control and Prevention (CDC) released its annual “Sexually Transmitted Disease Surveillance Report.” According to the data for 2016, the prevalence of sexually transmitted diseases (STDs) is the highest ever recorded in the country’s history. About 1.6 million Americans were diagnosed with chlamydia, about 470,000 were diagnosed with […]
09Jan

ICD-10-CM Coding for Catheter-Associated Urinary Tract Infection (CAUTI)

Catheter-associated urinary tract infection (CAUTI) is the most common infections that patients acquire within healthcare facilities. According to a study published in BMC Health Services Research in May 2017, urinary tract infections in general account for up to 36 percent of the infections that are acquired within healthcare facilities, and around 80 percent are associated […]
09Jan

The Challenges of Interpreting Electronic Medical Records (EMR) for Medical Coding Purposes

When electronic medical records (EMR) were first introduced, some observers predicted that electronic documentation would mean that medical coding inaccuracies would soon be a thing of the past. Indeed, today’s EMR systems include algorithms that can automatically make front-end edits and catch documentation mistakes, thereby preventing certain miscommunications between physicians and coders — which would […]
09Jan

Dental-Medical Cross Coding for Wisdom Tooth Removal

Every year, millions of people have their wisdom teeth removed. Although it is not necessary for all patients, estimates indicate that around 85 percent of people need to have their wisdom teeth removed at some point during their life in order to prevent significant dental problems. If your small dental practice offers wisdom tooth removal […]
09Jan

The Complexities of PIP Billing in “No Fault” Auto Insurance States

If you are a health care provider at a small practice, you might be surprised to find out that the auto insurance laws in your state have the potential to significantly impact your revenue cycle. This is particularly true in states that have “no fault” auto insurance laws. Under this type of system, the auto […]
09Jan

Is Medicare the Primary or Secondary Payer? Working with Patients Who Have Multiple Insurance Plans

Medicare provides health insurance coverage for more than 55 million Americans — over 15 percent of the population — and that number is expected to rise to about 79 million by 2030. Individuals who are 65 years or older, disabled, or have end-stage renal disease are eligible for Medicare Part A (hospital insurance) and Medicare […]
09Jan

Implications of CDT Changes for Dental-Medical Cross Coding

Every year, the American Dental Association (ADA) updates its coding standards within the Current Dental Terminology (CDT) code set. For instance, as we discussed in a previous post, the 2017 changes included eleven code additions, one code deletion, and five code revisions. Several of these code changes have implications for dental-medical cross coding. It is […]
09Jan

CPT Coding for Gastric Emptying Imaging Studies

For physicians, chronic digestive issues are some of the most difficult to diagnose. When a patient complains of stomach pain, irregular bowel movements, or abdominal bloating, there are a wide range of possible culprits. The reason for the patient’s discomfort could be as innocuous as a food intolerance, or it could be as serious as […]