Claims Clearinghouse

ICD-10 Is Coming October 1, 2013, It’s Closer Than It Seems… Or Is It?

Published on February 17, 2012 by Marty Briggs in ICD 10. 0 Comments

Many physicians around the country recently received an email from the Centers for Medicare and Medicaid Services (CMS) warning of the impending ICD-10 implementation deadline of October 1, 2013, with the misleading header seen below.

ICD 10 Transition CMS

However, only a few paragraphs into the email, the reality of CMS’ confusion concerning ICD-10 becomes gravely apparent, as they contradict their own opening statement with Health and Human Services’ (HHS) nebulous start date:

“The final rule adopting ICD-10 as a standard was published in January 2009 and set a compliance date of October 1, 2013 – a delay of two years from the compliance date initially specified in the 2008 proposed rule. HHS will announce a new compliance date moving forward.” Continue reading…

Procedure and Diagnosis Pre-Coding — Can your EHR make your billing team coding angels?

Published on May 2, 2011 by Seth Flam DO in Claims Clearinghouse. 0 Comments
Medical claims billing angel

In our last blog we discussed how important suggestive Evaluation and Management (E/M) coding is for physicians. MediTouch EHR simplifies E/M coding but unlike many EHRs our system also has additional automated methods that work with your billing team to assist with other non-E/M procedure codes and even diagnosis codes. MediTouch EHR is a completely integrated EHR/Billing/Clearinghouse system and because of that level of integration it can make coding at the point of care simpler for doctors. Before a provider even sees a patient, much, if not all of the encounter can be pre-coded.

How does pre-coding work? For years our practice management system has supported the concept of claim templates — pre-coded claims that code themselves for visits that are repetitive. If you see patients for repetitive visits or if your staff knows how you code for certain visit types then pre-coding via claim templates makes coding simple. Your staff simply saves a favorite claim as a template and associates it with an encounter in your schedule. Continue reading…

Evaluation and Management Coding — May we suggest a code?

Published on April 19, 2011 by Seth Flam DO in Claims Clearinghouse. 0 Comments
Piles-of-Paperwork

Many physicians do not know how to code. It’s hard to believe that a task that physicians execute many times each day is performed improperly over and over again. Pretty bold statement, but I have the evidence, at least as it relates to family docs. In 2001 the Journal of the American Board of Family Medicine published a study on the Accuracy of CPT Evaluation and Management Coding by Family Physicians. In general the study showed that physicians were chronically undercoding! It is counter-intuitive that doctors would be “cheating” themselves. There is of course a logical explanation. First of all, physicians are under-trained with regard to coding, especially Evaluation and Management coding. Doctors are usually not trained in medical school on how to code properly and when coding rules change they are too busy to enroll in billing classes. In addition physicians are terrified of over-coding. They abhor the possibility that they will be negatively profiled or penalized by insurance companies. Doctors recognize that insurance companies try to view their coding through the prism of the old-fashioned bell curve. Providers are resigned to the fact that no matter how hard they work and how much time they spend with a patient they can not bill E/M codes accurately for the excellent service they provide. Physicians are usually not shy about billing for their hard work, but why do they become timid with regard to E/M coding? Continue reading…