On January 1, 2021, the American Medical Association will implement the largest change to the CPT* evaluation and management (E/M) office visit codes in almost 30 years. The code changes impact some of the most frequently used E/M codes (office and other outpatient visit codes 99201-99205 and 99211-99215) requiring significant changes in provider office and… Read More »Implementation Guidance for FY21 E/M Code Changes
Please click the button below to download a copy of Staci Josten’s ACDIS Lightening Round presentation from the ACDIS Virtual Conference, “Second Level Reviews: Two Heads are Better Than One.”
Topic: Poisoning/Overdose Scenario: 65 yr. old female with Metastatic Bone Cancer on oral Dilaudid with Chronic Back Pain due to the cancer H&P: Pt arrived to the ER due to diminished responsiveness per family and found to have hypersomnolence. CT of head ordered and negative for stroke, labs reveal nothing significant. Per review of prior… Read More »Monthly CDI Scenario Discussion – August 2020
Click here to download UASI’s client newsletter from the third quarter of 2020.
Topic: E-cigarette or Vaping – Associated Pulmonary Lung Injury (EVALI) Scenario: 23 year old female presents with shortness of breath and cough for one week. No known history. She is attending school at the local community college. Patient works part-time at a local bar on the weekends. History & Physical: HPI: 23 year old presents with… Read More »Monthly CDI Scenario Discussion – July 2020
Topic: Deep Tissue Injury and Pressure Ulcers Scenario: 88-year-old female patient with wound to buttock H&P: HPI: 88-year-old female brought in from nursing home facility with concern of an open wound to left buttock. Patient has contractures due to previous CVA with left-sided hemiparesis. Patient is limited in mobility due to obesity. PMH: CVA left-sided… Read More »Monthly CDI Scenario Discussion – June 2020
Topic: HIV Scenario: 65 year old hemophiliac presents with poor appetite, difficulty swallowing, and weight loss History and Physical: HPI: Recently moved to the US; reports poor appetite and sore throat over the last 3 months; reports being unable to get out of bed for a week; at patient’s last office visit, his lab work… Read More »Monthly CDI Scenario Discussion – May 2020
Top Documentation and Coding issues to include in 2020 Compliance Plans What’s in your 2020 compliance plan? Make sure you are addressing these top ten documentation and coding compliance concerns. For Hospitals Risk-based review of inpatient DRG cases, examples include: RAC DRG targets Clinical indicators, cases at risk for clinical denials (e.g. Sepsis, CHF, ARF,… Read More »Top 10 Compliance Issues 2020
The Centers for Medicare & Medicaid Services (CMS) lifted Medicare restrictions on the use of telehealth services during the COVID-19 emergency. TELEHEALTH FACTS: Effective March 1, Medicare will pay physicians for telehealth services at the same rate as in-person visits for all diagnoses, not just services related to COVID-19 Medicare patients can receive telehealth services… Read More »Important Telehealth Coding Advice during COVID-19
Click here to download UASI’s client newsletter from the second quarter of 2020.