Modifiers are the key to overriding Correct Coding Initiative (CCI) edits, so let’s give them the attention they deserve. We’ll start with a recent rule update and move on to helpful hints about CCI-associated modifiers in general. Which CCI edits? Our focus here will be Medicare CCI Procedure-to-Procedure (PTP) edits for physicians and practitioners.

Although International Classification of Diseases, Tenth Revision, Clinical Modification (ICD-10-CM) took effect on Oct. 1, 2015, there still are many gaps in the understanding and use of the code set. ICD-10-CM is the standard transaction code set for diagnostic purposes under the Health Insurance...

CMS has provided ICD-10-CM coding updates for fiscal year 2020 that include 273 additions 21 deletions and 30 revisions, according to the American Health Information Management Association. The 21 deletions for the fiscal year beginning Oct. 1, 2019, and ending Sept. 30:

Just like our patients, proper coding and billing for obstetric patients can be…complicated. As a coding instructor and compliance auditor, I field a lot of questions from new students and experienced billers alike. In this article, I’ll break down a few of the most important concepts you need to understand to master obstetric coding.

In an era of value-based reimbursements, rising overheads, changing codes, and increased scrutiny of claims by health insurance companies, dermatology medical billing and coding has become quite complex. Dermatology practices need to overcome the challenges of documentation and...

You might think that you could rely on the accuracy of a Medicare Administrative Contractor (MAC) policy, but apparently, you can’t. First, I’d like to extend thanks to my colleague Sharon for sending me WPS’s deeply...