Its Wednesday

Wed, 16 Mar 2016 19:31:51 GMT

We have made it to the half-way mark. We have skimmed some areas that cover a lot of information.

and just for fun and a little trivia which is definitely NOT on the assessment--do you know which modifier is under discussion by CMS to do away with altogether? Of course it is modifier 25.

Now on to other topics. review HCPCS or at least what it is and what it is generally used for

As far as some general questions on ICD and CPT one could be:

ICD codes are generally updated annually in:

A--January

B--March

C: October

D: December

answer is C for October

EM codes ---Evaluation and Management

do you know the different types? New Patient, Established Patient and consultation

and what drives the level of each procedure code? how many levels there are?

Wed, 16 Mar 2016 19:41:54 GMT

Do you know which codes in E&M only have to document for 2 of the 3 elements?

this would be your established patients and the three elements involved are Medical Decision Making, History, and the examination itself.

And the guidelines for examination used are which guidelines? 1997

Review the requirements for consultations----what makes the visit a consultation and not just a new patient visit.

There is a ton of information contained in the 1997 documentation guidelines for evaluation and management. If you don't have the resource manual which contains the guidelines in the appendices this can be accessed online. Keeping in mind we won't ask you to code from an operative report.

Within operations the points hit on this week are just the tip and are all considered part of the revenue cycle management process.

Take a moment to look up what are the main portions of revenue cycle management from the patient management side and the billing management side.

Wed, 16 Mar 2016 22:21:58 GMT

On the patient side of Revenue Cycle Management you have

Patient Demographics Entry which goes to Insurance verification
This then moves into the billing management side for coding of services
Then to charge entry
Then to claims submission
which goes next payments and payment processing.

From payment processing it either moves to a self pay follow-up on the patient side or insurance or denial management

When you go through the review on these areas think about everything that goes into each process---every step of the process from how do you get your patient demographics, to the day you close the account as paid in full.

Make use of the appendix for operations if you have the resource manual---if not then take each topic listed such as Medical Records Retention, Coding and browse the web. Also, this website is a good source of info from past discussion board entries. There are more sample questions out there from last years review over the summer of 2015.

Before the week is out we will be hitting risk management and compliance.

If the info being given is too basic let us know as we are eager to make sure everyone gets what you need. How involved to you want to go on topics? Otherwise we just keep posting