Q/A: What if my Patient Refuses to Fill out the Outcome Assessment Questionnaire?

Question:
What if my Medicare patient refuses to fill out the outcome assessment questionnaire?
Answer:
Inform the patient that Medicare requires that you demonstrate functional improvement in order for them to determine if the care is medically necessary. In other words, they may have to pay for the care out of pocket if …

Understanding NCCI Edits

Medicare creates and maintains the National Correct Coding Initiative (NCCI) edits and NCCI Policy Manual, which identify code pair edits. When performed on the same patient, on the same day, and by the same provider, the secondary code is considered an integral part of the primary code, and payment for …

Documenting Diagnoses Like a Peer Reviewer

The right ICD-10 code is the one that matches the documentation. Does your record clearly distinguish between sciatica and radiculopathy? Do you know which codes are excluded from being billed alongside myositis? You will leave this presentation with a clear understanding of what to document for the diagnoses you use most, and match it to the CPT code that makes the most sense. Dr. Gwilliam, a certified auditor and ICD-10 Instructor will show you the way.

Chiropractic is Still Showing up on the OIG Work Plan

The Office of Inspector General’s (OIG) mission is to protect the integrity of Department of Health & Human Services (HHS) programs as well as the health and welfare of program beneficiaries.  They are dedicated to combating fraud, waste and abuse and to improving the efficiency of HHS programs, such as …