Apr 10, 2013 | Uncategorized
Saturday:
nL55.9 – SunburnnR61 – SweatingnW29.3xxA – Contact with powered garden tools, initial encountern
Tuesday:
nT33.90 – FrostbitenX37.2xxA – Injury due to blizzard, initial encounternW29.8xxA – Contact with snow shovel, initial encounternnIn preparation for the upcoming deadline for ICD-10 implementation, Welter Healthcare Partners presents weekly ICD-10 Codes of the Week! Our goal is to familiarize you with the new and expanded code set and the additional clinical documentation needed from your providers to comply with ICD-10 coding, and more importantly, for accurate and clean claims submission to keep your revenue stream flowing! We are to help YOU prepare for the October 1, 2014 implementation date. Please don’t hesitate to contact us for all of your training and education needs!
Apr 10, 2013 | Uncategorized
To All Health Care Professionals, Providers, and Suppliers:n
Mandatory Payment Reductions in the Medicare FFS (Fee-for-Service) Program – “Sequestration”
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The Budget Control Act of 2011 requires, among other things, mandatory across-the-board reductions in Federal spending, also known as sequestration. The American Taxpayer Relief Act of 2012 postponed sequestration for 2 months. As required by law, President Obama issued a sequestration order on March 1, 2013. The Administration continues to urge Congress to take prompt action to address the current budget uncertainty and the economic hardships imposed by sequestration.nnThis listserv message is directed at the Medicare FFS program (i.e., Part A and Part B). In general, Medicare FFS claims with dates-of-service or dates-of-discharge on or after April 1, 2013, will incur a 2 percent reduction in Medicare payment. Claims for durable medical equipment (DME), prosthetics, orthotics, and supplies, including claims under the DME Competitive Bidding Program, will be reduced by 2 percent based upon whether the date-of-service, or the start date for rental equipment or multi-day supplies, is on or after April 1, 2013.nnThe claims payment adjustment shall be applied to all claims after determining coinsurance, any applicable deductible, and any applicable Medicare Secondary Payment adjustments.nnThough beneficiary payments for deductibles and coinsurance are not subject to the 2 percent payment reduction, Medicare’s payment to beneficiaries for unassigned claims is subject to the 2 percent reduction. The Centers for Medicare & Medicaid Services encourages Medicare physicians, practitioners, and suppliers who bill claims on an unassigned basis to discuss with beneficiaries the impact of sequestration on Medicare’s reimbursement.nnQuestions about reimbursement should be directed to your Medicare claims administration contractor. As indicated above, we are hopeful that Congress will take action to eliminate the mandatory payment reductions.
Apr 3, 2013 | Uncategorized
Medicare PECOS Edits Begin May 1, 2013 – Claim Denials Possible
nEffective May 1, 2013, the Centers for Medicare & Medicaid Services (CMS) will turn on the Phase 2 denial edits. This means that Medicare will deny claims for services or supplies that require an ordering/referring provider to be identified and that provider is not identified, is not in Medicare’s enrollment records, or is not of a specialty type that may order/refer the service/item being billed.nnThe Affordable Care Act, Section 6405, “Physicians Who Order Items or Services are Required to be Medicare Enrolled Physicians or Eligible Professionals,” requires physicians or other eligible professionals to be enrolled in the Medicare Program to order or refer items or services for Medicare beneficiaries. Some physicians or other eligible professionals do not and will not send claims to a Medicare contractor for the services they furnish and therefore may not be enrolled in the Medicare program. Also, effective January 1, 1992, a physician or supplier that bills Medicare for a service or item must show the name and unique identifier of the attending physician on the claim if that service or item was the result of an order or referral. Effective May 23, 2008, the unique identifier was determined to be the National Provider Identifier (NPI). The Centers for Medicare & Medicaid Services (CMS) has implemented edits on ordering and referring providers when they are required to be identified in Part B, DME, and Part A HHA claims from Medicare providers or suppliers who furnished items or services as a result of orders or referrals.nnThis means that starting May 1, Medicare will deny claims for Medicare-covered services ordered/referred by a physician for durable medical equipment, prosthesis, orthotics and services (DMEPOS), clinical lab, radiology services and certification of home health if the physician does not have a Medicare profile in the Medicare enrollment system, PECOS. The Centers for Medicare & Medicaid Services (CMS) says physicians who order such services and are not enrolled should do so immediately, or the applications may not be processed before May 1.nnSo if you order or refer items or services for Medicare beneficiaries and you do not have a Medicare enrollment record, you need to submit an enrollment application to Medicare. You can do this using the Internet-based Provider Enrollment, Chain, and Ownership System (PECOS) or by completing the paper enrollment application (CMS-855O). Review the background and additional information below and make sure that your billing staff is aware of these updates.n
The Ordering and Referring Files n
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The downloads below contain the National Provider Identifier (NPI) and legal name (last name, first name) of all physicians and non-physician practitioners who are of a type/specialty that is legally eligible to order and refer in the Medicare program and who have current enrollment records in Medicare (i.e., they have enrollment records in PECOS).nnA new file will be made available periodically that will replace the posted file; at any given time, only one file (the most recent) will be available. The file can be downloaded by users with technical expertise and further sorted or manipulated. It can also be used to search for a particular physician or non-physician practitioner by NPI or by name. Please note the following: (1) Records are in alphabetical order based on the surname of the physician or non-physician practitioner. (2) Name suffixes (e.g., Jr.), if they exist, are not displayed. (3) There are no “duplicates” in the file. Many physicians or non-physician practitioners share the same first and last name; their corresponding NPIs are the assurance of uniqueness. (4) Deceased physicians and non-physician practitioners are not included in the file.nnThere are two file formats for the Medicare Ordering and Referring File below. The first is a PDF format. This file will allow a user to verify that an individual physician or eligible professional has an approved enrollment record in PECOS using Adobe Acrobat Reader. The second file is a ZIP file. The ZIP file contains the same information as the PDF, however, the file is a CSV format. The CSV file will allow users to open the Ordering and Referring data in Excel, Notepad and other software formats that could be easier for users to search/sort.nnIn order to use the CSV file, please left-click on the “Medicare Ordering and Referring File [ZIP, 64400KB]” and save the CSV document contained in the zipped download. Right-click on the saved CSV file, select “Open With” on the task bar and select the program through which you would like open the Medicare Ordering and Referring File.nnUsers must have the most recent version of Adobe Acrobat Reader and/or Excel in order to open the PDF and/or CSV file.nnThe new Initial Physician and Non-Physician Applications Pending Contractor Review files are lists of applications pending contractor review. These pending applications have NOT been processed by the CMS contractors. These lists have been compiled to allow individuals the ability to verify that an application has been submitted and is awaiting processing.nnThe downloads below are the most recent versions of the O&R file. For a specific create date, please review each document individually.n
Educational Material MLN Matters® article #SE1305 Full Implementation of Edits on the Ordering/Referring Providers in Medicare Part B, DME and Part A Home Health Agency (HHA) Claims.
nMedicare Enrollment Guidelines for Ordering/Referring ProvidersnnThe Basics of Medicare Enrollment for Physicians Who Infrequently Receive Medicare Reimbursementn
Downloads
nMedicare Ordering and Referring File – PDF [ZIP, 32MB] nnMedicare Ordering and Referring File – CSV [ZIP, 9MB] nnInitial Physician Applications Pending Contractor Review [ZIP, 228KB] nnInitial Non Physician Applications Pending Contractor Review [ZIP, 92KB]nn[hr]Click here for more information.n
Need help with PECOS enrollment? Call us today!
nSource: www.envoynews.com; April 3, 2013.
Apr 3, 2013 | Uncategorized
J30.1 – Hay fevernnJ30.81 – Rhinitis due to animal dandernnJ30.2 – Seasonal allergiesnnJ30.89 – Rhinitis due to feathersnnL23.7 – Allergic Dermatitis due to plantsnnIn preparation for the upcoming deadline for ICD-10 implementation, Welter Healthcare Partners presents weekly ICD-10 Codes of the Week! Our goal is to familiarize you with the new and expanded code set and the additional clinical documentation needed from your providers to comply with ICD-10 coding, and more importantly, for accurate and clean claims submission to keep your revenue stream flowing! We are to help YOU prepare for the October 1, 2014 implementation date. Please don’t hesitate to contact us for all of your training and education needs!
Mar 29, 2013 | Uncategorized
W61.33xA – Pecked by Easter chick, Initial EncounternnT62.8x1A – Food Poisoning, accidental, Initial Encounter, old hard-boiled Easter EggnnF40.218 – Easter Bunny Phobiann nnIn preparation for the upcoming deadline for ICD-10 implementation, Welter Healthcare Partners presents weekly ICD-10 Codes of the Week! Our goal is to familiarize you with the new and expanded code set and the additional clinical documentation needed from your providers to comply with ICD-10 coding, and more importantly, for accurate and clean claims submission to keep your revenue stream flowing! We are to help YOU prepare for the October 1, 2014 implementation date. Please don’t hesitate to contact us for all of your training and education needs!
Mar 29, 2013 | Uncategorized
CAQH recently launched a new solution to enroll in EFT with participating payers through a universal process! Enrollment is easy!nnUsing CAQH’s EFT Enrollment utility, providers can securely enroll in electronic payment programs with payers. The site streamlines enrollment in these programs by eliminating the multiple and different forms required by each payer, and centralizing EFT enrollment between multiple payers. Once the information is entered, making changes for your practice can be done quickly and easily.n
Go to https://solutions.caqh.org for more information.
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Source: www.caqh.org; January 30, 2013.
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Healthcare and Reimbursement Updates
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Mar 29, 2013 | Uncategorized
On March 13, 2013, the Centers for Medicare & Medicaid Services (CMS) issued a ruling contrary to its traditional billing policy regarding payment of Part B inpatient services following denial of a Part A claim. Ruling CMS-1455-R came about in response to an increasing number of Administrative Law Judge (ALJ) and Medicare Appeals Council decisions relating to RAC audit appeals which, while upholding Part A denials based on determinations that inpatient admissions were not reasonable and necessary, ordered payment under Part B as if services were rendered at an outpatient or “observation level” of care. The Ruling allows providers to submit Part B inpatient claims for a more expansive range of services upon denial of Part A claims during RAC appeals.nnUnder the Ruling, a hospital may submit Part B inpatient claims for services beyond those listed in the Medicare Benefit Policy Manual (MBPM) when:n
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- A Medicare review contractor denies the Part A inpatient claim upon finding that the inpatient admission was not reasonable and necessary;
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- The Part B services would have been payable to the hospital if the beneficiary was treated initially as an outpatient; and
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- The billed services do not require outpatient status, e.g. outpatient visits, emergency department visits, and observation services.
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nThe Ruling allows hospitals to submit Part B claims for payment provided the hospital withdraws its appeal on the corresponding Part A claim. The Ruling applies to Medicare claims denied by RAC auditors after March 13, 2013, or Medicare claims in a pending RAC appeal at any level as of March 13, 2013. Going forward from this Ruling, the scope of RAC appeals will be limited to review of Part A inpatient claims, and ALJs are not to order Part B payment or remand for consideration of Part B payment.nnLastly, the Ruling sets forth the time period within which a provider must bill the Part B claims. Generally speaking, hospitals must submit Part B claims within 180 days of receipt of an appeal dismissal notice, final or binding unfavorable appeal decision, or determination of a Part A inpatient claim for which there is no pending appeal and for which the hospital does not appeal. Further, Part B inpatient and outpatient claims filed later than one year after the date of service will not be rejected as untimely, provided the denied Part A inpatient claim was timely filed.n
CMS Proposed Rule
nConcurrent with the Ruling, CMS released a proposed rule on Part B inpatient billing that would apply on a prospective basis. Following a Part A claims denial due to inpatient admissions that are not reasonable and necessary, the proposed rule similarly allows payment for reasonable and necessary Part B services had the beneficiary been treated as an outpatient. Likewise, the proposed rule excludes payment for services that require outpatient status. However, unlike the Ruling, the proposed rule also applies when a hospital determines after discharge that a beneficiary’s inpatient admission was not reasonable and necessary. Further, the proposed rule continues to apply timely filing restrictions on Part B billing for inpatient services; contrary to the Ruling, any Part B services must be filed within one year from the date of service.n
What Providers Should Know
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- Providers should keep this Ruling in mind when reviewing RAC denials to make strategic decisions, that is, the choice between 1) pursuing Part A payments by arguing that inpatient admission was reasonable and necessary versus 2) dropping the appeal and re-billing the claim as Part B inpatient.
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- Because hospitals still cannot bill for observation services when an inpatient admission is denied, the Ruling will not significantly affect medical services billing but may affect billing for procedures.
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nSource: www.polsinelli.com; March 13, 2013.n
Healthcare and Reimbursement Updates
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Mar 29, 2013 | Uncategorized
Health care providers are REQUIRED to complete Compliance Certification! The Centers for Medicare & Medicaid Services (CMS) requires that all Humana business partners, including health care providers, complete required compliance training and certifications.
nHealth care providers can complete this information online via Humana’s secure Compliance website, which requires internet access. To access the website, health care providers must be registered on Humana.com or Availity.com. Detailed instructions and additional information on completing these requirements, including registration, are available here. While health care providers are encouraged to complete the compliance requirements within 30 days of notification, these requirements must be completed no later than December 31, 2013.nnSource: www.humana.com; February 2, 2013.n
Healthcare and Reimbursement Updates
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Mar 29, 2013 | Uncategorized
In what appears to be a shift in policy, the Centers for Medicare & Medicaid Services has begun auditing providers attesting to Meaningful Use of their electronic health record systems before doling out incentive payments, according to a report from the American Academy of Family Physicians (AAFP).
nCMS has targeted 5 to 10 percent of those who attested to Meaningful Use in January 2013, according to Elizabeth Holland, director of the Health IT Initiative Group’s Office of E-Health Standards and Services. Eligible professionals selected for audit were chosen both “randomly” and “based on protocols that identify suspicious or anomalous attestation data,” according to the AAFP News Now article.nnAn additional 5 to 10 percent of physicians and others will be subject to post-payment audits, according to Holland. The audits are being conducted by Garden City, NY-based CPA firm Figliozzi and Company.nnCMS is required to conduct audits of providers attesting under the EHR incentive program, and began postpayment audits in July 2012. However, the U.S. Department of Health & Human Services’ Office of Inspector General (OIG) chastised CMS in November 2012 for poor auditing of the incentive program, a concern echoed by the Government Accountability Office.nnOIG specifically recommended that CMS conduct prepayment audits of a select number of providers before issuing their incentive payments. At that time, CMS would not concur with the OIG’s recommendation, saying that prepayment audits would impose a “huge new burden” on providers and impede EHR adoption.nnOther CMS programs are moving from “pay and chase” to prepayment review. GAO recently reported that expanding prepayment audits could save Medicare $115 million.nnTo learn more, here’s the AAFP New Now articlennSource: www.fierceemr.com; Marla Durben Hirsch; March 24, 2013.n
Healthcare and Reimbursement Updates
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Mar 29, 2013 | Uncategorized
Be on the lookout! Humana staff members regularly conduct medical record audits in randomly selected physician offices to help satisfy regulatory compliance by evaluating physician compliance with adopted medical record documentation guidelines. The minimum passing score is 85 percent compliance with the guidelines, with a goal of 90 percent. These guidelines are available for downloading and printing at Humana.com; click on the PDF entitled “Medical Records Guidelines” under the list of Clinical Practice Guidelines.nnSource: www.humana.com; February 2, 2013.n
Healthcare and Reimbursement Updates
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Mar 21, 2013 | Uncategorized
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Reimbursement Issues (denials, late payments, incorrect payments, inaccurate information)n
- Expanded insurance coverage provisions through the Affordable Care Act (ACA)
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- Data collection for meaningful use and reimbursement incentives
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- Expanded credentialing requirements create a new and more complex environment for providers and healthcare facilities
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Reimbursement models are changing and Payer Relationship Management (PRM) is more important than ever!
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- A strategic approach to understanding and cultivating payer relationships is the key to success. They need you and you need them!
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- Understanding your own data will assist in cultivating financially positive relationships – knowledge is power!
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Take control of your Payer Relationships!
nPRM supports your providers, practices and facilities to capture, store, monitor, track and leverage all information related to the billing and reimbursement processes. This information includes detailed and up-to-date provider profiles (credentialing), practice profiles (leverage), payer profiles (market research), reimbursement activities (proper payments), and patient care activities and efforts (data collection).n
PRM is the lifeline of your practice and facility—
n—and requires expertise, knowledge, and a multidisciplinary approach of professionals who understand and stay ahead of the changing healthcare environment and requirements. Every practice and facility should focus on PRM to maximize revenue by:n
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- Incorporating tools and systems to report and understand your practice’s financial health, financial needs, and patient care data
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- Understanding the current relationship with reimbursement sources (i.e. payers), including language, rates, etc.
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- Understanding your market, your competition, and most importantly your value!
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- Identifying opportunities to increase reimbursement (leverage)
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- Verifying all provider and contract information is loaded correctly in payer systems to ensure proper and timely payments (credentialing)
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- Understanding new reimbursement models to obtain additional payments (i.e. incentive payments), and avoid penalties that will decrease revenue
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- Ensuring efficient reimbursement processes to maximize cash flow (i.e. EFT, ERA)
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nNeed Assistance with your PRM? Click here…
Mar 21, 2013 | Uncategorized
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While there’s no code for Spring Fever, many people can’t wait for:
nY93.52 – Activity, horseback ridingnY93.83 – Activity, roughhousing and horseplaynY93.66 – Activity, soccernY93.53 – Activity, golfnY93.01 – Activity, walking, marching and hikingnnIn preparation for the upcoming deadline for ICD-10 implementation, Welter Healthcare Partners presents weekly ICD-10 Codes of the Week! Our goal is to familiarize you with the new and expanded code set and the additional clinical documentation needed from your providers to comply with ICD-10 coding, and more importantly, for accurate and clean claims submission to keep your revenue stream flowing! We are to help YOU prepare for the October 1, 2014 implementation date. Please don’t hesitate to contact us for all of your training and education needs!
Mar 15, 2013 | Uncategorized
T65.6X1A – Poisoning from green dye in beer, initial encounternR53.83 – Fatigue due to exhaustively searching for 4-leaf clovernY00.xxxA – Assault by blunt object (pot o’gold) thrown by leprechaun at the end of the rainbow, initial encounternW22.02xA – Injury incurred by walking into lamppost during St. Patty’s Day Parade, initial encounter.nnIn preparation for the upcoming deadline for ICD-10 implementation, Welter Healthcare Partners presents weekly ICD-10 Codes of the Week! Our goal is to familiarize you with the new and expanded code set and the additional clinical documentation needed from your providers to comply with ICD-10 coding, and more importantly, for accurate and clean claims submission to keep your revenue stream flowing! We are to help YOU prepare for the October 1, 2014 implementation date. Please don’t hesitate to contact us for all of your training and education needs!
Mar 15, 2013 | Uncategorized
Last week at the Annual HIMSS13 conference in New Orleans, Marilyn Tavenner, Acting CMS Administrator, confirmed that the ICD-10 implementation date of October 1, 2014 will stand!nnProviders, practices, hospitals and other healthcare entities need to start their preparation and training efforts NOW! CMS has released ICD-10 resources, including timelines and checklists, to help with a successful transition and implementation.n
Upcoming Free ICD-10 Seminars and Webinars
nEnglewood, CO: Swedish Medical CenternSpruce C Conference Roomn501 E Hampden AvenuenEnglewood, CO 80113nnDate: Wednesday April 10, 2013nTime: 2-4pmnn
Mar 7, 2013 | Uncategorized
The New Era of Healthcare and the Affordable Care Act (ACA) is bringing monumental changes and obstacles to physician and hospital reimbursement and operations – expanded insurance coverage through Medicaid and Health Insurance Exchanges, data collection including ICD-10 transition and meaningful use, and payer audits to ensure proper provider documentation and coding.nnStay up to date with these recent payer announcements:nnMedicaid Primary Care Payment IncreasenThe Affordable Care Act (ACA) enacted changes to Medicaid primary care reimbursement. Eligible physicians will receive supplemental payments for services rendered between January 1, 2013 and December 31, 2014. These supplemental payments will raise the Medicaid reimbursement to Medicare rates. To be eligible for the supplemental payments, physicians must self-attest as having a specialty in family medicine, general internal medicine, and/or pediatric medicine. Only physicians can complete the attestation! Staff or other representatives are not allowed to complete the attestation on the provider’s behalf.nClick here to complete provider attestation.n
Centers for Medicare and Medicaid Services (CMS) – Transmittal 1165, Change Request 8109
nImplementation Date: April 1, 2013nnEffective Date: October 1, 2014nnSubject: ICD-10 Conversion from ICD-9 and Related Code Infrastructure of the Medicare Shared Systems as They Relate to CMS National Coverage Determinations (NCDs).nnSummary: To both create and update national coverage determination (NCD) hard-coded shared system edits that contain ICD-9 diagnosis codes with comparable ICD-10 diagnosis codes plus all associated coding infrastructure such as procedure codes, HCPCS/CPT codes, denial messages, frequency edits, POS/TOB/provider specialties, etc.nnThe implementation date is prior to the effective date in order to be prepared to meet the timeline to implement the new ICD-10 diagnosis codes on October 14, 2014. The shared systems began implementation of the necessary changes to the NCDs in the January 2013 systems release and continue with CRs in subsequent releases.nnClick here for full content of CMS Transmittal 1165, and spreadsheet showing all affected ICD-9 codes and their corresponding ICD-10 codes as they relate to their respective NCDs, in addition to the rest of the coding infrastructure specific to each NCD.nn[vc_toggle title=”Medicare (Novitas)” size=”sm” el_id=””]n
Novitas is resuming with the revalidation process as of March 1, 2013.nnNovitas average processing time for applications has increased to 90 days—as a result of incentive program deadlines and transition from Trailblazer.[/vc_toggle]nn[vc_toggle title=”Anthem BCBS (CO) – Change to Imaging Guidelines” size=”sm” el_id=””]n
Effective April 15, 2013 the following AIM clinical appropriateness imaging guidelines will be revised for the purpose of expanding requirements to increase conservative therapy prior to imaging; clarify appropriate imaging for inflammatory and infectious etiologies; and to expand guidelines for the work-up of tumors:n
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- CT Cervical Spine, Thoracic Spine and Lumbar Spine
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- MRI Cervical Spine, Thoracic Spine and Lumbar Spine
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- CT Upper Extremity
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- MRI Lower Extremity
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nThese clinical guidelines can be accessed on AIM’s website at www.aimspecialtyhealth.com.nnDrug fee schedule update: CMS average sales price (ASP) first quarter fee schedule (effective 1/1/13) will go into effect on February 1, 2013. To view the ASP fee schedule, go to CMS website at www.cms.hhs.gov [/vc_toggle]nn[vc_toggle title=”Anthem BCBS – Central Region (IN, KY, MO, OH, WI)” size=”sm” el_id=””]n
Robotic Assisted Surgery – Facility ReimbursementnnEffective May 8, 2013, Anthem will not allow additional payment for charges associated with robotic technology. The use of robotic technology is considered integral to the primary surgery being performed and not eligible for separate reimbursement.[/vc_toggle]n[vc_toggle title=”UnitedHealthcare” size=”sm” el_id=””]nn
TRICARE West Region: UnitedHealthcare Military and Veterans launched the TRICARE West Region website www.uhcmilitarywest.com on February 15, 2013. The website will be updated with new information for TRICARE network providers until the contract transitions to UnitedHealthcare on April 1, 2013. Contracting is underway! Practices/providers will need to return the Demographic Form and/or Service Code Listing as these are important components of your agreement with UnitedHealthcare Military and Veterans.nnRevision to Documentation Requirements for Modifier 22: Effective June 2013, UnitedHealthcare will follow CMS guidelines and require a concise statement outlining how the service differs from the usual service performed, in addition to the operative report before the additional 20% in reimbursement will be considered.nnRevision to Speech Therapy Policy (Physical Medicine and Rehabilitation): Effective the second quarter of 2013, the Speech Therapy Policy will be revised to deny reimbursement for CPT codes 99201-99499 when reported by speech and language therapists/pathologists.nnChanges to Prior Authorization List: Effective for dates of service on or after April 1, 2013, UnitedHealthcare West and commercial plans will require prior authorization for skilled nursing and private duty nursing in addition to nutritional services for home health coverage.[/vc_toggle]nn[vc_toggle title=”Cigna” size=”sm” el_id=””]n
Coming soon – One website for all Cigna Patient information: CignaforHCP.com. Practices will be able to verify eligibility and benefits, precertification requirements and submit requests, checking claim status, check details of processed claims, important updates and more![/vc_toggle]n[vc_toggle title=”Aetna” size=”sm” el_id=””]n
Specialists need to be on the lookout for requests from Aetna to review selected medical records for office visits. The purpose is to compare the provider’s documentation and the coding that was submitted on the claim form. Requests are based on provider trends in coding relative to his peers in the same specialty, and the characteristics of the claim. The affected specialties are:n
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- Dermatology
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- ENT
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- Hand surgery
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- Neurology
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- Neurosurgery
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- Orthopedic surgery
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- Pain management
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- Physiatry
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- Plastic surgery
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- Podiatry
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- Sports medicine
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- Urology
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nAetna will also review medical records for procedures in Dermatology and Urology.[/vc_toggle]
Mar 7, 2013 | Uncategorized
ICD-9 code: 642.93 – Unspecified hypertension complicating pregnancy, childbirth and the puerperium, antepartum condition.nnIn order to code this in ICD-10, you would need to know:n
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- Is the hypertension pre-existing, or gestational?
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- Is the hypertension secondary?
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- Are there associated complications from the hypertension, such as edema, or pre-eclampsia, and if so, is the pre-eclampsia mild, moderate, or severe? If severe pre-eclampsia, is there associated HELPP syndrome?
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- What trimester of pregnancy is the patient in?
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- How many weeks gestation?
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nCheck your provider’s current documentation! Does it meet these requirements?nnRelated ICD-10 Code (to the above): Z63.1 – Problems in relationship with in-lawsnnIn preparation for the upcoming deadline for ICD-10 implementation, Welter Healthcare Partners presents weekly ICD-10 Codes of the Week! Our goal is to familiarize you with the new and expanded code set and the additional clinical documentation needed from your providers to comply with ICD-10 coding, and more importantly, for accurate and clean claims submission to keep your revenue stream flowing! We are to help YOU prepare for the October 1, 2014 implementation date. Please don’t hesitate to contact us for all of your training and education needs!
Mar 1, 2013 | Uncategorized
We just received news that our upcoming Seminars and Webinar, titled ICD-10: A Coder’s Perspective, are now approved for 2 AHIMA CEU’s!nnSeminar Title: ICD-10: A Coder’s PerspectivenSeminar Cost: FREEnDon’t miss out on this excellent opportunity!nnSeminar Dates and Locations:nnEnglewood, CO: Swedish Medical CenternSpruce C Conference Roomn501 E Hampden AvenuenEnglewood, CO 80113nnDate: Wednesday April 10, 2013nTime: 2-4pmnnThis class is full and can no longer accept new registrants. Please register for our Thornton, CO class if you wish to attend, or the webinar listed below. Webinar Date and Description:nWebinar Title: ICD-10: A Coder’s PerspectivenWebinar Cost: FREEnDon’t miss out on this excellent opportunity!nWebinar Date: Thursday April 25th from 11am – 1pm Mountain time (1 pm Eastern)nnSeminar/Webinar Description: An informative seminar to give a coder’s viewpoint of the ICD-10 transition and to alleviate fears of what the new code set will mean to coders and billers. We will review guideline changes, new concepts and problematic code sets, along with in-depth discussions of the impact to outpatient coders, tips on how to begin the education and training process, and tips on how to avoid potential pitfalls during the implementation process.nnThis program has the prior approval for 2.0 CEU’s from the American Academy of Professional Coders (AAPC) and American Health Information Management Association (AHIMA).nn2 Convenient ways to register:n
nNote: You will receive confirmation of your registration within 72 hours. If you do not receive a confirmation, please call Jennifer at 303.534.0388.nnStay up to date by checking our News Blog!nn
Feb 27, 2013 | Uncategorized
Webinar Title: ICD-10: A Coder’s PerspectivenWebinar Cost: FREEnDon’t miss out on this excellent opportunity!nWebinar Date: Thursday April 25th from 11am – 1pm Mountain time (1 pm Eastern)nnWebinar Description: An informative webinar to give a coder’s viewpoint of the ICD-10 transition and to alleviate fears of what the new code set will mean to coders and billers. We will review guideline changes, new concepts and problematic code sets, along with in-depth discussions of the impact to outpatient coders, tips on how to begin the education and training process, and tips on how to avoid potential pitfalls during the implementation process.nnThis program has the prior approval for 2.0 CEU’s from the American Academy of Professional Coders (AAPC) and American Health Information Management Association (AHIMA).nnSpace is limited! Go-to-Meeting details and powerpoint presentation slides will be emailed to registered participants 2 days prior to Webinar event. Please be sure to provide your email as part of your registration.nnTo register, fill out the form below, or click here to download and fax in your form to 303.534.0393. Fields marked with an asterisk (*) are required.[gravityform id=”6″ name=”ICD-10 Webinar” title=”false” description=”false”]nnNote: Confirmation of registration will be sent within 72 hours. If you do not receive a confirmation, please call Jennifer at 303.534.0388.nnTo receive updates on upcoming seminars, webinars, and training, join our email registration!nn‘Live’ Seminar Dates and Locations: ICD-10: A Coder’s Perspectiven
Swedish Medical CenternSpruce C Conference Roomn501 E Hampden AvenuenEnglewood, CO 80113nnDate: Wednesday April 10, 2013n Time: 2-4pmnnThis class is full and can no longer accept new registrants. Please register for our Thornton, CO class if you wish to attend, or the webinar listed above.
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Feb 26, 2013 | Uncategorized
X36.1 – AvalanchenV86.42xA – Person injured while boarding snowmobile, initial encounternW00.9xxA – Unspecified fall due to ice and snow, initial encounternX31.xxxA – Exposure to excessive natural cold, initial encounternV98.3xxA – Accident on ski lift, initial encounternn nnIn preparation for the upcoming deadline for ICD-10 implementation, Welter Healthcare Partners presents weekly ICD-10 Codes of the Week! Our goal is to familiarize you with the new and expanded code set and the additional clinical documentation needed from your providers to comply with ICD-10 coding, and more importantly, for accurate and clean claims submission to keep your revenue stream flowing! We are to help YOU prepare for the October 1, 2014 implementation date. Please don’t hesitate to contact us for all of your training and education needs!
Feb 21, 2013 | Uncategorized
CERTIFIED PROFESSIONAL CODER (CPC) PREPARATION COURSE & CERTIFICATIONnn
Certified coders are in high demand! Advance your career in the medical field and get certified now while maintaining your current schedule!
nThis course will be offered as a combination live and web-based (streaming of the live class) class to offer maximum flexibility for any student. After each live session, a video of the class will be uploaded (in case you miss a class!), while exclusive access to previous material, practice exams, current course material, powerpoint presentations, and more will be provided to each registrant. With limited time left to register, make sure you sign up today!nnThis course is designed to offer the most comprehensive and complete coding information to prepare students for the CPC examination and a career in the medical field. This course will include an brief overview of medical terminology, anatomy, CPT, ICD-9 CM and HCPCS manuals, and coding scenarios for practical application in the work environment.nnUpon completion of this course, participants will be prepared to sit for the nationally accredited American Academy of Professional Coders (AAPC)/Certified Professional Coder (CPC) coding certification examination.nnThis examination will be offered to class participants at the completion of the course.nnCourse Schedule: CPC Classes begin Tuesday, April 30, 2013. Classes will be held every Tuesday from 5:30 PM–8:30 PM, and every other Saturday from 9:00 AM–12:30 PM. The final exam is on June 27, 2013.nnCourse Format: While also offered live, the course is being offered as a web–based as well so as to offer maximum flexibility for any student.nn nnClass size is limited, so register today to guarantee your spot!nnRegistration Deadline: Tuesday, April 16, 2013.nnClick here for more information.nnClick Here for Course Schedule and Registration Form.
