News & Information
Find the latest news from the Haugen Consulting Group. Check back frequently for updates.
In the outpatient world, physicians are accustomed to seeing services as the key to reimbursement, but as healthcare shifts toward value-based care, severity and outcomes will increasingly factor into reimbursement as well. | Read More.
Medicare covers a range of preventive services to promote health by identifying and addressing problems early on when treatment is most effective. However, many eligible patients and some providers may not be fully aware of the benefits described in Your Guide to Medicare’s Preventive Services. | Read More.
As coders, we often face dilemmas without benefit of clear guidance, creating the feeling of being pulled in different directions. In today’s audit environment, coders need practical solutions to succeed in a setting of conflicting expectations. This article focuses on coding and clinical criteria dilemmas, and the value of having a facility policy for coding in these situations. | Read More.
Question: Can we claim transitional care management (TCM) codes 99495 or 99496 on a patient who is discharged to hospice? Answer: Almost certainly not if it’s in a facility. If it’s home hospice, though, and you fulfill the requirements, you have a pretty strong case to get paid. | Read More.
As healthcare organizations create and manage vast quantities of electronic data from various sources, record retention has become an increasingly vital and challenging aspect of information governance. Providers are pressed to make tough decisions—what to keep, what to destroy, and how to retain or archive information in a cost-effective manner.
Many uphold the idea that storage is cheap—why not keep records forever? However, a “keep everything” approach is not a practical long-term plan. | Read More.
Question: When two surgeons are working a patient, when is modifier 62 (Two surgeons) appropriate and when is modifier 80 (Assistant surgeon) appropriate?
Answer: If you’re going to bill 62, the procedure must “really need the individual skills of two surgeons to even perform — a complex nature, like certain spine or heart transplant procedures,” says Corina Marquardt, CPC, CPMA, senior consultant with the Haugen Consulting Group in Denver.
CMS helps you figure out whether these modifiers are appropriate by listing co-surgery and assistant-at-surgery status indicators in the relative value file of the Medicare physician fee schedule. | Read More.
AS HEALTHCARE ORGANIZATIONS move toward value-based models, health information management (HIM) and information technology (IT) must work together to strengthen relationships while promoting population health, accountable care, and information governance (IG) initiatives. | Read More.
One of the hardest jobs for coders is to translate physician terminology into ICD-10 coding terminology. This has been especially challenging with codes related to mental and behavioral health. In some cases during the year following ICD-10 implementation , there was no way to convert DSM-5 terminology used by psychiatrists and psychologists to ICD-10-CM. Lack of understanding of the differences between the code sets led to misinterpretation and frustration among coders and mental health professionals. | Read More.
Of all the challenges associated with the transition to ICD-10-PCS, coding spinal fusion procedures is by far the most difficult to tackle, in this author’s opinion. Even after training, many coders still struggle with the complexities of coding these procedures. This article focuses on the importance of thoroughly reviewing operative reports and offers valuable insights and practical strategies for ensuring accuracy, improving efficiency, and avoiding costly errors. | Read More.
Patient registration is the gateway to quality care and data integrity for hospitals and health systems. Patient access staff are the catalyst for the financial health of every account, essentially “teeing up” the future success of each claim. Because of the influence these personnel have on positive patient experiences and strong revenue cycles, many hospital leaders are working to manage the following patient access department challenges. | Read More.
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