Coding With Modifiers
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| Author | : Robin L. Linker |
| Publisher | : American Medical Association Press |
| Total Pages | : 0 |
| Release | : 2020 |
| Genre | : Medical |
| ISBN | : 9781640160378 |
"Coding with Modifiers, 6th Ed, is the ultimate resource for modifier guidelines. This revised edition provides guidance on how and when to use modifiers in order to avoid costly payment delays and denials. Coding with Modifiers uses real-life modifier scenarios and medical records to guide correct CPT® and HCPCS modifier usage. Modifiers create clear, concise communications between the provider and payer, and are essential to the coding process. Clinical documentation improvement and other pertinent considerations highlight important clinical documentation improvements for each modifier and related best practices to ensure correct modifier usage. Provides guidelines from CPT, CMS, third-party payers, and NCCI to explain how and when to use modifiers to avoid payment delays and denials"--
| Author | : Susan E. Garrison |
| Publisher | : |
| Total Pages | : 0 |
| Release | : 2015-11-23 |
| Genre | : |
| ISBN | : 9781556454837 |
JustCoding's Guide to Modifiers: Hospital Outpatient Edition Susan E. Garrison, CHCA, CHCAS, CCS-P, CHC, PCS, FCS, CPAR, CPC, CPC-H Modifiers are a frequent audit target of CMS and the Office of Inspector General, with focused efforts against modifiers such as -25 and -59. JustCoding's Guide to Modifiers: Hospital Outpatient Edition features a comprehensive explanation of when to report each CPT(R)/HCPCS modifier, including coding tips and the latest regulations and guidance. Each chapter contains exercises that let you use real-life documentation, including operative reports and case studies, to test your knowledge on how to apply each modifier. This book will review the most recent guidance for each modifier, with citations from relevant regulatory documents. Table of Contents About the Author 1. Introduction 2. National Correct Coding Initiative Modifiers(Subsections: Modifiers -59, -XE, -XS, -XP, -XU, -58, -76 to -79, and -91)3. Evaluation and Management Modifiers (Subsections: Modifiers -25 and -27) 4. Anatomical Modifiers(Subsections: Modifiers -50, -RT, -LT, -E1 to -E4, -F1 to -F9, -FA, -LC, -LD, -LM, -RC, -RI, -T1 to -T9, and -TA)5. Reduced/Discontinued Services Modifiers (Subsections: Modifiers -52, -53, -73, and -74) 6. Medical Necessity Modifiers(Subsections: Modifiers -GA, -GX, -GY, and -GZ)7. Screening Services Modifiers(Subsections: Modifiers -GG and -PT)8. Outpatient Therapy Modifiers(Subsections: Modifiers -GN to -GP and -KX)9. Miscellaneous Modifiers(Subsections: Modifiers -CA, -ET, -JW, and -PA to -PC)10. Modifier Coding Compliance Quiz 11. Answer Key Benefits: Properly use modifiers to prevent audits Reduce confusion about when to use modifiers Get coding tips to clarify regulatory guidance and provide examples of which modifiers apply in different situations Access case studies and operative reports to test your knowledge of modifiers
| Author | : Deborah J. Grider |
| Publisher | : American Medical Association Press |
| Total Pages | : 0 |
| Release | : 2013-10-30 |
| Genre | : Nosology |
| ISBN | : 9781603598934 |
Modifiers create clear, concise communications between the provider and payer, and are essential to the coding process. This fifth edition provides guidance on how and when to use modifiers in order to avoid costly payment delay and denials. New to this edition is a new chapter using real-life cases that contain modifier usage. These cases will help build usage skills and aid in the correct use of CPT(R) and HCPCS modifiers. Features and Benefits - New chapter -- modifier scenarios using real medical record patient encounters to build modifier usage skills - Coding tips -- explains how to use specific modifiers to clear up confusion around modifier usage - Modifiers approved for hospitals and ASCs -- provide information for professional service and hospital reporting requirements - Teaching tools -- enable content testing using AMA-developed questions and answers - Test-Your-Knowledge questions -- nearly 200 test questions to help determine comprehension of the material
| Author | : Deborah J. Grider |
| Publisher | : American Medical Association Press |
| Total Pages | : 436 |
| Release | : 2004 |
| Genre | : Business & Economics |
| ISBN | : |
Don't forget about the modifier. Missing or incorrect usage of modifiers is the most common reason that claims are rejected by payors. Leave off a modifier, or put in the wrong one, and your claim may be denied or paid the wrong amount. Coding with Modifiers: A Guide to Correct CPT and HCPCS Level II Modifier Usage provides step-by-step guidance for the proper use of CPT and HCPCS modifiers. Also included are specific requirements for modifier usage in both professional service and hospital reporting.
| Author | : American Medical Association |
| Publisher | : |
| Total Pages | : 250 |
| Release | : 2021-11 |
| Genre | : |
| ISBN | : 9781640161344 |
For a better understanding of the latest revisions to the CPT(R) code set, rely on the CPT(R) Changes 2022: An Insider's View. Get the insider's perspective into the annual changes in the CPT code set directly from the American Medical Association.
| Author | : American Medical Association |
| Publisher | : |
| Total Pages | : 1250 |
| Release | : 2021-09-20 |
| Genre | : |
| ISBN | : 9781640161559 |
ICD-10-CM 2022: The Complete Official Codebook provides the entire updated code set for diagnostic coding, organized to make the challenge of accurate coding easier. This codebook is the cornerstone for establishing medical necessity, correct documentation, determining coverage and ensuring appropriate reimbursement. Each of the 22 chapters in the Tabular List of Diseases and Injuries is organized to provide quick and simple navigation to facilitate accurate coding. The book also contains supplementary appendixes including a coding tutorial, pharmacology listings, a list of valid three-character codes and additional information on Z-codes for long-term drug use and Z-codes that can only be used as a principal diagnosis. Official 2022 coding guidelines are included in this codebook. FEATURES AND BENEFITS Full list of code changes. Quickly see the complete list of new, revised, and deleted codes affecting the CY2022 codes, including a conversion table and code changes by specialty. QPP symbol in the tabular section. The symbol identifies diagnosis codes associated with Quality Payment Program (QPP) measures under MACRA. New and updated coding tips. Obtain insight into coding for physician and outpatient settings. Chapter 22 features U-codes and coronavirus disease 2019 (COVID-19) codes Improved icon placement for ease of use New and updated definitions in the tabular listing. Assign codes with confidence based on illustrations and definitions designed to highlight key components of the disease process or injury and provide better understanding of complex diagnostic terms. Intuitive features and format. This edition includes color illustrations and visual alerts, including color-coding and symbols that identify coding notes and instructions, additional character requirements, codes associated with CMS hierarchical condition categories (HCC), Medicare Code Edits (MCEs), manifestation codes, other specified codes, and unspecified codes. Placeholder X. This icon alerts the coder to an important ICD-10-CM convention--the use of a "placeholder X" for three-, four- and five-character codes requiring a seventh character extension. Coding guideline explanations and examples. Detailed explanations and examples related to application of the ICD-10-CM chapter guidelines are provided at the beginning of each chapter in the tabular section. Muscle/tendon translation table. This table is used to determine muscle/tendon action (flexor, extensor, other), which is a component of codes for acquired conditions and injuries affecting the muscles and tendons Index to Diseases and Injuries. Shaded guides to show indent levels for subentries. Appendices. Supplement your coding knowledge with information on proper coding practices, risk-adjustment coding, pharmacology, and Z-codes.
| Author | : Optum |
| Publisher | : |
| Total Pages | : 0 |
| Release | : 2013-09 |
| Genre | : |
| ISBN | : 9781601518842 |
Optum Learning: Understanding Modifiers uses actual medical records to outline in detail how to document services and apply the correct modifiers. The book was developed as an educational tool for physicians and their staff, as well as billers and coders of hospital outpatient services and ASC services. Features and benefits Optum Edge-Includes all AMA CPTr Modifier Updates Optum Edge-Educational format. Easy-to-use format for every experience level, for use in the classroom or on the job. Optum Edge-World Wide Web resources. Supplies all of the up- to-date links a coder needs to find accurate modifier information online. Optum Edge-Decision tree flow charts. Coder learn how to choose the correct modifier when more than one could apply. Optum Edge-Real-life clinical examples. Use to reduce claim denials by supplying correctly used modifiers and completed CMS- 1500 forms. 2014 changes to modifiers and their guidelines included.
| Author | : American Medical Association |
| Publisher | : |
| Total Pages | : 1200 |
| Release | : 2021-09-17 |
| Genre | : |
| ISBN | : 9781640160873 |
CPT(R) 2022 Professional Edition is the definitive AMA-authored resource to help healthcare professionals correctly report and bill medical procedures and services.
| Author | : American Medical Association |
| Publisher | : American Medical Association Press |
| Total Pages | : 0 |
| Release | : 2017 |
| Genre | : Medical |
| ISBN | : 9781622025510 |
The newest edition of this best-selling educational resource contains the essential information needed to understand all sections of the CPT codebook but now boasts inclusion of multiple new chapters and a significant redesign. The ninth edition of Principles of CPT(R) Coding is now arranged into two parts: - CPT and HCPCS coding - An overview of documentation, insurance, and reimbursement principles Part 1 provides a comprehensive and in-depth guide for proper application of service and procedure codes and modifiers for which this book is known and trusted. A staple of each edition of this book, these revised chapters detail the latest updates and nuances particular to individual code sections and proper code selection. Part 2 consists of new chapters that explain the connection between and application of accurate coding, NCCI edits, and HIPAA regulations to documentation, payment, insurance, and fraud and abuse avoidance. The new full-color design offers readers of the illustrated ninth edition a more engaging and far better educational experience. Features and Benefits - New content! New chapters covering documentation, NCCI edits, HIPAA, payment, insurance, and fraud and abuse principles build the reader's awareness of these inter-related and interconnected concepts with coding. - New learning and design features -- Vocabulary terms highlighted within the text and defined within the margins that conveniently aid readers in strengthening their understanding of medical terminology -- "Advice/Alert Notes" that highlight important information, exceptions, salient advice, cautionary advice regarding CMS, NCCI edits, and/or payer practices -- Call outs to "Clinical Examples" that are reminiscent of what is found in the AMA publications CPT(R) Assistant, CPT(R) Changes, and CPT(R) Case Studies -- "Case Examples" peppered throughout the chapters that can lead to valuable class discussions and help build understanding of critical concepts -- Code call outs within the margins that detail a code description -- Full-color photos and illustrations that orient readers to the concepts being discussed -- Single-column layout for ease of reading and note-taking within the margins -- Exercises that are Internet-based or linked to use of the AMA CPT(R) QuickRef app that encourage active participation and develop coding skills -- Hands-on coding exercises that are based on real-life case studies
| Author | : American Medical Association |
| Publisher | : |
| Total Pages | : 1000 |
| Release | : 2020-09-17 |
| Genre | : |
| ISBN | : 9781640160491 |
CPT® 2021 Professional Edition is the definitive AMA-authored resource to help health care professionals correctly report and bill medical procedures and services. Providers want accurate reimbursement. Payers want efficient claims processing. Since the CPT® code set is a dynamic, everchanging standard, an outdated codebook does not suffice. Correct reporting and billing of medical procedures and services begins with CPT® 2021 Professional Edition. Only the AMA, with the help of physicians and other experts in the health care community, creates and maintains the CPT code set. No other publisher can claim that. No other codebook can provide the official guidelines to code medical services and procedures properly. FEATURES AND BENEFITS The CPT® 2021 Professional Edition codebook covers hundreds of code, guideline and text changes and features: CPT® Changes, CPT® Assistant, and Clinical Examples in Radiology citations -- provides cross-referenced information in popular AMA resources that can enhance your understanding of the CPT code set E/M 2021 code changes - gives guidelines on the updated codes for office or other outpatient and prolonged services section incorporated A comprehensive index -- aids you in locating codes related to a specific procedure, service, anatomic site, condition, synonym, eponym or abbreviation to allow for a clearer, quicker search Anatomical and procedural illustrations -- help improve coding accuracy and understanding of the anatomy and procedures being discussed Coding tips throughout each section -- improve your understanding of the nuances of the code set Enhanced codebook table of contents -- allows users to perform a quick search of the codebook's entire content without being in a specific section Section-specific table of contents -- provides users with a tool to navigate more effectively through each section's codes Summary of additions, deletions and revisions -- provides a quick reference to 2020 changes without having to refer to previous editions Multiple appendices -- offer quick reference to additional information and resources that cover such topics as modifiers, clinical examples, add-on codes, vascular families, multianalyte assays and telemedicine services Comprehensive E/M code selection tables -- aid physicians and coders in assigning the most appropriate evaluation and management codes Adhesive section tabs -- allow you to flag those sections and pages most relevant to your work More full color procedural illustrations Notes pages at the end of every code set section and subsection
