Blog & Publications
Find the latest news from the Haugen Consulting Group. Check back frequently for updates!
The coding information and guidance in these posts are valid at the time of publishing. Learners are encouraged to research subsequent official guidance in the areas associated with the topic as they can change rapidly.
Rigorous documentation, diagnosis coding pays off in risk-adjusted reimbursement
Publication: JustCoding
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.
Making the most of Medicare Preventive Services
Publication: MGMA Connection
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.
Coding and Clinical Criteria: The Value of an Escalation Policy
Publication: ICD10 Monitor
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.
You can claim TCM for patients who elect hospice — if they’re at home
Publication: Part B News
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.
How to Craft an Effective Record Retention Policy
Publication: Health Data Management
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.
Uniting HIM and IT
Publication: Journal of AHIMA
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.
Use Modifier 62 for Surgeon Duos Using Same Code, but Make Sure You Can Justify It
Publication: Part B News
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.
ICD-10-CM Mental Health Code Changes
Publication: ICD10 Monitor
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.
2016 Articles Featuring HCG
A year in ICD-10: Healthcare professionals weigh in
CD-10 did not have the negative impact many industry stakeholders predicted. But coders’ frenzied preparation for the Oct. 1, 2015 compliance date did have a silver lining…
Small providers may struggle as ICD-10 ‘grace period’ ends
With Saturday marking the one-year anniversary of the implementation of ICD-10 codes, healthcare organizations must now focus on some new requirements that went into effect on October 1.
Spinal Fusion Procedures
Publication: ICD10 Monitor
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.