19 results.
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Back to Basics: APC Payment Methodology
Author: Tomak, Tracey
Source: CodeWrite | AHIMA newsletter article
Publication Date: April 2017
In August of 2000, the Centers for Medicare and Medicaid Services (CMS) introduced the Ambulatory Payment Classifications (APCs) under the Outpatient Prospective Payment System (OPPS). The objective of the APC payment system was to control costs and increase efficiencies for outpatient ser....
CY 2017 OPPS Update
Author: Comfort, Angie
Source: Journal of AHIMA - Coding Notes | Journal of AHIMA
Publication Date: February 2017
As last year drew to a close, facilities began the looming task of reviewing the Hospital Outpatient Prospective Payment System (OPPS) final rule to ensure their chargemaster and systems were up-to-date with the 2017 changes. The final rule for calendar year (CY) 2017 was released on Novem....
New Changes De-Spookify Modifier -59
Author: Wilson, Donna D
Source: Journal of AHIMA - website
Publication Date: October 30, 2014
The proper application of modifier -59 (Distinct Procedural Service) has mystified many a coder. The Centers for Medicare and Medicaid Services (CMS) has recently indicated that modifier -59 is the most commonly used and abused of all the modifiers—mainly due to the fact that it is used to....
Modifers – ‘Friend or Foe’
Author: Swindle, Jennifer
Source: AHIMA Convention
Publication Date: October 02, 2011
ABSTRACT:
Background: The need for modifiers to further and appropriate identify accurate coding information to all payers is critical for appropriate and accurate reimbursement. Failure to use modifiers can have a negative impact on a physician or an organizations’ revenue as witho....
Spinal Surgery in CPT/HCPCS Unraveled
Author: Kuehn, Lynn
Source: AHIMA Convention
Publication Date: October 02, 2011
Introduction
Spinal surgery can involve a combination of nervous system and musculoskeletal system procedures. Understanding the definitions, anatomy and procedure concepts of these systems provides a foundation for use by the coder in correctly assigning codes in multiple classification....
Observation Services
Author: Hapner, Peggy
Source: AHIMA Convention
Publication Date: September 25, 2010
Observation is a necessary, though cumbersome, service provided in hospitals today. Many facilities would like to see observation eliminated because it is a logistical nightmare, particularly when it comes to charges and reimbursement.
The most stringent rules about observation....
Casting Conundrum: Correct Coding for Casts, Splints, and Strapping
Author: Nelson, Tanai S; Benjamin, Christina
Source: Journal of AHIMA - Coding Notes
Publication Date: July 2009
Correctly coding casts, splints, and strapping can be confusing. Much of the confusion is related to what type of materials are classified as casts, splints, or strapping; whether the CPT application codes or the HCPCS level II codes should be assigned; and whether the work performed is includ....
Key Issues in the 2009 OPPS Final Rule
Author: Clark, Andrea
Source: Journal of AHIMA - Coding Notes
Publication Date: March 2009
The final rule for the 2009 Outpatient Prospective Payment System (OPPS) includes multiple revisions that hospitals must address in their practices, policies, and operations. Hospitals should develop strategies for analyzing the financial impact and operational challenges by reviewing the foll....
Coding Radiology Services
Author: Walk, Gerri
Source: Journal of AHIMA - Coding Notes
Publication Date: January 2009
Because coding and radiology departments often share accountability for the quality of outpatient radiology coding, it is important that coding professionals share coding issues and charge capture expectations with radiology staff. This article outlines methods to improve the quality of coded....
Coding Cardiovascular Catheterization: Accuracy Requires a Multidisciplinary Effort
Author: Lenahan, Monica
Source: Journal of AHIMA - Coding Notes
Publication Date: January 2009
Cardiac catheterization procedures involve the insertion of a catheter into a chamber or vessel of the heart for investigational and interventional purposes. A small puncture is made most commonly in the femoral artery in the groin region. A guidewire is then inserted into the incision and thr....
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