Medical Coding Pro Newsletter - Remember Diagnosis to Support 62311 Post-Op

Published: Mon, 05/16/11


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Remember Diagnosis to Support 62311 Post-Op - 2011-05-09 12:42:11-04
Question: Our state’s Medicaid carrier denies our claims when we submit 62311 with modifier 59 for postoperative pain management. They say the 62311 is bundled with the anesthesia procedure code. How should we handle this?  -Ohio Subscriber Answer: ...

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Put Your ePrescribing Knowhow Into Meaningful Use - 2011-05-10 06:26:54-04

Get your system moving before June 30th or you’ll pay the price.

If you do not have an electronic prescribing (ePrescribing or eScribing) system yet in place, or have not integrated one into your electronic medical record (EMR) system, you better get a move on it. You only have until June 30, 2011 to submit at least ten claims to Medicare demonstrating that you are a successful eScriber for 2011. Otherwise, you are at risk of not only losing the bonus in 2011 but according to the rulemaking for 2011, also facing penalties assessed, reducing your Medicare fee schedule by 1 percent in 2012.

With limited time, it is smart to consider a stand-alone internet based system which you can implement relatively easy. You could get this system up and running right away, at a low cost, with simplified a implementation timeline and without depending on your electronic health record (EHR) selection and implementation which is both much more extensive, costly and more complicated to implement.

If you’re still asking, “Can our practice afford not to adopt ePrescribing?” Then, the answer is NO. Today you need to start doing something.

Background: eScribing is part of Centers for Medicare and Medicaid Services’ (CMS) incentive program called the Physician Quality Reporting System (PQRS). PQRS offers incentives to practices that meet CMS-set goals for the implementation and practice of electronic prescription on a regular basis. The system was designed with “a carrot and a stick”. While we have been enjoying the “carrot” for the past few years, the “stick is on the cusp of being implemented as of June 30th per the 2011 Rulemaking. CMS will pay you when you implement eScribing in 2011 (a 1 percent bonus), it will penalize you when you don’t put it into practice, a 1percent penalty...



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Follow 3 Tips to Improve Your A/R Process and Boost Your Collections - 2011-05-10 07:05:51-04

Avoid the ‘code it, bill it, and forget it’ mentality — don’t be afraid to follow up on your claims.

The economic downturn coupled with looming healthcare changes means that your practice — and all others — are under more pressure than ever to collect every penny you deserve.  You can refine your accounts receivable (A/R) process quickly and easily to bring in the money without a lot of extra effort.

A/R defined: “Accounts receivable (A/R) is the money that is owed to the practice,” explains Elin Baklid-Kunz, MBA, CPC, CCS, a director of physician services in Daytona, Fla., during The Coding Institute’s audioconference “Top A/R Tactics: Fight Back Against Lower Payments and Increased Government Scrutiny.”

Follow these three best practices to set your practice on an improved A/R track and avoid thousands in lost reimbursement.

1. Monitor Each Claim You Send Out

The first step in perfecting your A/R process is to make sure someone in your practice is paying attention to what happens to every claim you submit. Ask questions such as: “did the insurance company even receive the claim?” and “Did the patient pay her copay portion of the bill?”  “There are companies out there I call ‘code it, bill it, and forget it companies,’” says coding, billing, and practice management consultant Steven M. Verno, CMBS, CMSCS, CEMCS, CPM-MCS, in The Coding Institute’s audio conference “Reveal and Recover Hidden Money You Didn’t Know You Missed.”

“They code the claim, they bill the claim, and then they forget about it. They leave it out there and don’t do anything to bring the money in. They don’t follow up on the claim.”  Following up on your submitted claims early in the game can save you time. First ensure that once your practice submits a claim that it is...



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