19 results.
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....
Clarifying the Infusion and Injection Quandary
Author: Johnson, Laurie M.
Source: Journal of AHIMA - Coding Notes | Journal of AHIMA
Publication Date: September 2007
Coding infusions and injections has been a source of confusion and frustration since the Centers for Medicare and Medicaid Services (CMS) introduced C codes in 2006. However, in calendar year 2007, CMS made an about face and eliminated the C codes, reverting back to the published 2007 CPT....
AHIMA Comments on Requested HCPCS Code Revisions
Author: Bowman, Sue E
Source: AHIMA testimony and comments
Publication Date: June 15, 2005
June 15, 2005
HCPCS National Panel
c/o Centers for Medicare & Medicaid Services
ATTN: Cindy Hake
Mail Stop C5-08-27
7500 Security Boulevard
Baltimore, Maryland 21244
RE: Comments on Requested HCPCS Code Revisions
Dear Ms. Hake:
The American....
Web FAQ
Author: AHIMA Coding Team
Source: AHIMA Q and A
Publication Date: October 2002
Who Has the Official Guidelines for Interpretation of Coding Guidelines or Appropriateness of Code Assignment?
For ICD-9-CM coding questions and guidelines we look to Cooperating Parties for ICD-9-CM. The National Center for Health Statistics and the Health Care Financing Administration receiv....
Laboratory Services Regulations Impact National Coverage Decisions, HIM
Author: Willard, Dianne
Source: Journal of AHIMA
Publication Date: October 2002
This is Part 2 of a two-part article on laboratory services regulations. Part 1, which appeared in the September Journal of AHIMA, dealt with the administrative policies contained in these regulations. Part 2 addresses the specific national coverage decisions that were developed as part of thi....
Testimony of the American Health Information Management Association to the National Committee on Vital and Health Statistics on Medical Code Sets
Author: Prophet, Sue
Source: AHIMA testimony and comments
Publication Date: February 06, 2002
February 6, 2002
Opening Comments
Good morning Mr. Chairman, members and staff of the National Committee on Vital and Health Statistics (NCVHS) Standards and Security subcommittee, ladies and gentlemen. I am Sue Prophet, director of coding policy and compliance for the American Heal....
Making a Proactive Transition to APCs
Author: Willett, Lyn
Source: Journal of AHIMA
Publication Date: July 2000
There's no doubt APCs are going to change the way your facility operates, but do you know how? By taking a look at your existing systems, you'll get a better idea of how to prepare for changes. This article spotlights specific functions to consider and optimize for the new outpatient prospect....
Diagnostic Services Coding Tips for Physician Offices
Author: Scichilone, Rita A
Source: Journal of AHIMA
Publication Date: July 1999
Coding for diagnostic services performed in physician offices and clinics requires an understanding of some special reporting guidelines. Here are some helpful tips.
The Question of Ownership
Reporting laboratory and radiology procedures depends on ownershi....
HCFA Requires Use of Modifiers for Hospital Outpatient Services
Author: Willard, Dianne
Source: Journal of AHIMA
Publication Date: June 1998
On January 7, 1998, the Health Care Financing Administration (HCFA) released the final instructions on hospital outpatient modifiers from Medicare Hospital Manual transmittal number 726 dated January 1998. These instructions were electronically released to the Medicare fiscal intermediaries,....
CCS Coding Competencies--ICD-9-CM and CPT/HCPCS Procedural Coding
Author: AHIMA
Source: Journal of AHIMA
Publication Date: May 1998
For Further Reference
The Cooperating Parties (AHIMA, American Hospital Association, Health Care Financing Administration, National Center for Health Statistics) publish official guidelines in the Coding Clinic for ICD-9-CM, available from the American Hospital Association.....