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
