Author

Chris Boucher
Chris Boucher has nearly 10 years of experience writing various newsletters and other products for The Coding Institute. His blog will cover several areas of coding and compliance, including CPT® coding, modifiers, HIPAA compliance and ICD-10 coding.

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    You cannot bill ‘extra help’ under lt rules.
    One of your full-time physicians goes on vacation – or sabbatical or maternity leave. Your practice employs a locum tenens (lt) to fill in for the missing physician. No problem, until you try to bill for the substitute physician’s services with Medicare – or payers who   Read more..
    Posted on 16 Dec, 2015
    By Chris Boucher
    Put Locum Tenens Physicians On 60-Day Clock
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    Rx pads, unprotected computers are theft hotspots.
    We all know the problems that can arise when a patient’s medical identity is stolen. Unfortunately for medical offices, these same identity thieves are trying to nab your practice’s information as well. Take some advice from CMS’s course “Safeguarding Your Medical Identity,” which showed practices how   Read more..
    Posted on 14 Dec, 2015
    By Chris Boucher
    Want to Trump Practice ID Thieves? Heed This Expert Advice
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    Medicare will only accept stamped signatures in cases of disability.
    When your physician or another provider performs a medical service for a Medicare patient, he must include either a handwritten or electronic signature in order to authenticate that fact. Consequences: If you submit claims without a signature that passes muster with Medicare, you could be in   Read more..
    Posted on 2 Dec, 2015
    By Chris Boucher
    Validate Signature Before Signing Off On Claims
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    CMS sets RVUs for 99497, 99498.
    If your physician treats a lot of elderly patients, you probably have experience with advance care planning (ACP): treatments options, life expectancy, etc. In 2015, CPT® introduced ACP codes 99497 (Advance care planning including the explanation and discussion of advance directives such as standard forms [with   Read more..
    Posted on 27 Nov, 2015
    By Chris Boucher
    Want to Get Paid for ACP? Medicare Ruling Means You Could in 2016
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    Here’s when you’ll use 80081 for panels.
    If you are coding for an OB-GYN office, you should know about a couple of changes coming your way in CPT® 2016. The skinny: there will be a new OB panel code, and several changes to fetal magnetic resonance imaging (MRI) coding. Read on for a   Read more..
    Posted on 24 Nov, 2015
    By Chris Boucher
    Check Out Changes to OB Panel, Fetal MRI Coding
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    Payer preference drives decision to use modifiers.
    If you’ve ever gotten a puzzling denial for a psychotherapy session provided by a clinical psychologist (CP) or clinical social worker (CSW), you’re not alone. There is many a coder who has been flummoxed by payer peculiarities for these services. The problem could have been as   Read more..
    Posted on 17 Nov, 2015
    By Chris Boucher
    You’ll Need AJ/AH Modifiers for Some CSW and CP Services
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    Using 87804 x 2 might result in denial.
    If you’re performing a test that detects the flu via immunoassay in the office, your provider might test for two strains of the virus. Impact: When you file these claims properly, you’ll be paid for two flu tests rather than one. Read on for a bit   Read more..
    Posted on 12 Nov, 2015
    By Chris Boucher
    Get Modifiers Right for Flu Multiple Flu Tests
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    Modifier separates E/M from normal surgical aftercare.
    When you’re coding for your provider’s surgical services, you’ll need to be familiar with modifier 24 in case the same provider performs an unrelated E/M service on the same patient during the postoperative (global) period. Avoid E/M denials during the postop period with this expert advice   Read more..
    Posted on 9 Nov, 2015
    By Chris Boucher
    Avoid Denials for Unrelated Postop E/Ms with Modifier 24
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    UC Berkeley IDs its interpretation of identifiers.
    When you’re facing the wrath of auditors – or worse – it’ll be too late to know what constitutes a HIPAA data breach and what doesn’t. Good news: There are 18 “identifiers” that the feds feel constitute a HIPAA breach, according to the University of California, Berkeley   Read more..
    Posted on 7 Nov, 2015
    By Chris Boucher
    Check This List for Most Common HIPAA Identifiers
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    Get more specific with new versions of these standard E/M codes.
    When the 2016 CPT® coding books come out, you’ll have a revised set of E/M codes that should make coding for prolonged services that include psychotherapy a lot easier. “It’s good to see that CPT® is including psychotherapy in the prolonged services code set,” says Suzan (Berman)   Read more..
    Posted on 6 Nov, 2015
    By Chris Boucher
    Use Updated Prolonged Services E/Ms to Capture Psychotherapy