EBOOK
About
All Physicians can increase their revenue and improve their compensation through accurate coding. This book tells you how. Written by nationally-renowned physician coding expert Betsy Nicoletti, The Field Guide to Physician Coding Third Edition delivers a payload of precise information on coding rules and relevant billing guidelines. Her explanations shed light on why the rules were created and how certain topics are linked to other information about which you must be aware. Nicoletti also steers you to critical source documents for today's coding rules so you don't have to spend hours hunting for key facts in long official documents. Sleep well knowing that your practice is compliant with government rules and you're collecting all of the money you are entitled to collect!
New for this Edition - Cloning Notes in an EHR Diagnosis Coding Transitional Care Management Foot Care Modifier 33 New Patient Coding Consults Wellness visits Changing Medicare Regulations Transition to ICD-10 PPACA/Health Reform Act No-nonsense advice supported by weblinks that answers the most pressing questions from physicians, practice managers, billers and coders. The "Rules" that help doctors get paid, not just the codes Organized alphabetically, by topic, for ease of use Relevance to all specialties Rules explained in plain, easy-to-understand prose Each entry includes: The definition of the service Clinical examples, when relevant Medical references, CPT rule references
Table of Contents
Accounts Receivable Benchmark Data Adjusted Collection
Ratio Advance Beneficiary Notice (ABN)
Aging Report
Assistant at Surgery Services
Care Plan Oversight (CPO) — CPT® Codes (NonMedicare) Care Plan
Oversight for Medicare Patients
Category of Code Charts
Certification of Home Health Services
Cerumen Removal
CLIA Waived Tests
Cloning Notes in an Electronic Health Record
Comprehensive Error Rate Testing (CERT)
Consolidated Nursing Home Billing
Consultations
Critical Care Services
Days in Accounts Receivable
Diagnosis Coding
Documentation Guidelines
Emergency Department Visits
Evaluation and Management Services and Profiles
Foot Care: Routine
General Principles of Medical Record Documentation
Global Surgical Package
Gross Collection Ratio
Healthcare Common Procedure Coding System (HCPCS) Hospital
Discharge Services
Hospital Initial Services, Inpatient
Hospital Observation Services
Hospital Subsequent Services
ICD-10-CM
Immunization Administration for Vaccinations
Incident to Services (Medicare)
Legibility
Local Coverage Determinations (LCDs)
Locum Tenens Billing
Medical Necessity
Medicare Physician Fee Schedule Database (MPFSDB)
Mini Mental Status Exam
Modifier 22
Modifier 24
Modifier 25
Modifier 26
Modifier 33
Modifier 50
Modifier 51
Modifier 55
Modifier 53
Modifier 58
Modifier 59
Modifier 78 and Modifier 79
Modifier PT
Multiple Endoscopic Procedures
Multiple Surgical Procedures
National Correct Coding Initiative (NCCI) National Coverage
Determinations (NCDs) New Patient
Nurse Visit
Nursing Facility Visits
Office of Inspector General (OIG) Work Plan
Patient Protection and Affordable Care Act (PPACA) aka Health Care Reform Act of 2010
Pelvic and Breast Clinical Exam Pre-operative Exams
Preventive Medicine Services
Preventive Medicine Services (Medicare) Prolonged Services
Reciprocal Billing Arrangements
Rev
New for this Edition - Cloning Notes in an EHR Diagnosis Coding Transitional Care Management Foot Care Modifier 33 New Patient Coding Consults Wellness visits Changing Medicare Regulations Transition to ICD-10 PPACA/Health Reform Act No-nonsense advice supported by weblinks that answers the most pressing questions from physicians, practice managers, billers and coders. The "Rules" that help doctors get paid, not just the codes Organized alphabetically, by topic, for ease of use Relevance to all specialties Rules explained in plain, easy-to-understand prose Each entry includes: The definition of the service Clinical examples, when relevant Medical references, CPT rule references
Table of Contents
Accounts Receivable Benchmark Data Adjusted Collection
Ratio Advance Beneficiary Notice (ABN)
Aging Report
Assistant at Surgery Services
Care Plan Oversight (CPO) — CPT® Codes (NonMedicare) Care Plan
Oversight for Medicare Patients
Category of Code Charts
Certification of Home Health Services
Cerumen Removal
CLIA Waived Tests
Cloning Notes in an Electronic Health Record
Comprehensive Error Rate Testing (CERT)
Consolidated Nursing Home Billing
Consultations
Critical Care Services
Days in Accounts Receivable
Diagnosis Coding
Documentation Guidelines
Emergency Department Visits
Evaluation and Management Services and Profiles
Foot Care: Routine
General Principles of Medical Record Documentation
Global Surgical Package
Gross Collection Ratio
Healthcare Common Procedure Coding System (HCPCS) Hospital
Discharge Services
Hospital Initial Services, Inpatient
Hospital Observation Services
Hospital Subsequent Services
ICD-10-CM
Immunization Administration for Vaccinations
Incident to Services (Medicare)
Legibility
Local Coverage Determinations (LCDs)
Locum Tenens Billing
Medical Necessity
Medicare Physician Fee Schedule Database (MPFSDB)
Mini Mental Status Exam
Modifier 22
Modifier 24
Modifier 25
Modifier 26
Modifier 33
Modifier 50
Modifier 51
Modifier 55
Modifier 53
Modifier 58
Modifier 59
Modifier 78 and Modifier 79
Modifier PT
Multiple Endoscopic Procedures
Multiple Surgical Procedures
National Correct Coding Initiative (NCCI) National Coverage
Determinations (NCDs) New Patient
Nurse Visit
Nursing Facility Visits
Office of Inspector General (OIG) Work Plan
Patient Protection and Affordable Care Act (PPACA) aka Health Care Reform Act of 2010
Pelvic and Breast Clinical Exam Pre-operative Exams
Preventive Medicine Services
Preventive Medicine Services (Medicare) Prolonged Services
Reciprocal Billing Arrangements
Rev