The Field Guide to Physician Coding, Second Edition

Written by nationally-renowned physician coding expert Betsy Nicoletti, The Field Guide to Physician Coding Second Edition delivers a payload of precise information on coding rules and relevant billing guidelines. Her explanations shed light on why the rules were created and how certain topics are linked to other information about which you must be aware. Nicoletti also steers you to critical source documents for today's coding rules so you don't have to spend hours hunting for key facts in long official documents. Sleep well knowing that your practice is compliant with government rules and you're collecting all of the money you are entitled to collect! New for this Edition! Consults Wellness visits Changing Medicare Regulations Transition to ICD-10 E-prescribing Modifiers 53, 58 PPACA/Health Reform Act This book should be on the desk of every clinician, biller and coder in the country! No-nonsense advice supported by weblinks and a CD that answers the most pressing questions from physicians, practice mangers, bilkers and coders. The "Rules" that help doctors get paid, not just the codes Organized alphabetically, by topic, for ease of use Relevance to all specialties Rules explained in plain, easy-to-understand prose Each entry includes: The definition of the service --Reimbursement rules related to the service 2006 RVUs Clinical examples, when relevant Medical references, CPT rule references The Field Guide to Physician Coding Table of Contents Accounts Receivable Benchmark Data Adjusted Collection Ratio Advance Beneficiary Notice Aging Report Allergen Immunotherapy Assistant at Surgery Services Care Plan Oversight CPT Codes (Non-Medicare) Care Plan Oversight for Medicare Patients Certification of Home Health Services Cerumen Removal CLIA Waived Tests Comprehensive Error Rate Testing (CERT) Consolidated Nursing Home Billing Consultations Critical Care Services Days in Accounts Receivable Diagnosis Coding Documentation Guidelines Emergency Department Visits E-Prescribing Evaluation and Management Services and Profiles General Principles of Medical Record Documentation Global Surgical Package Gross Collection Ratio Healthcare Common Procedure Coding System (HCPCS) Hospital Discharge Services Hospital Initial Services, Inpatient Hospital Observation Services Hospital Subsequent Services Immunization Administration for Vaccinations Incident to Services (Medicare) Legibility Local Coverage Determinations (LCDs) Locum Tenens Billing Medical Necessity Medicare Physician Fee Schedule Data Base (MPFSDB) Mini Mental Status Exam Modifier 22 Modifier 24 Modifier 25 Modifier 26 Modifier 50 Modifier 51 Modifier 52 Modifier 53 Modifier 58 Modifier 59 Modifier 78 and Modifier 79 Multiple Endoscopy Procedures Multiple Surgical Procedures National Correct Coding Initiative (NCCI) National Coverage Determinations (NCDs) New Patient Nurse Visit Nursing Facility Visits OIG Work Plan Patient Protection and Affordable Care Act (PPACA) aka Health Care Reform Act of 2010 Pelvic and Breast Clinical Exam Physicians Quality Reporting Initiative (PQRI) Pre-operative Exams Preventive Medicine Services Preventive Medicine Services (Medicare) Prolonged Services Recovery Audit Contractor Initiative Reciprocal Billing Arrangements Reviewing Medical Records Shared Visits (Medicare) Smoking Cessation Counseling Teaching Physician Rules Based on Time Teaching Physician Rules for Critical Care Services Teaching Physician Rules for Evaluation and Management Codes Teaching Physician Rules for Medical Students Teaching Physician Rules for Primary Care Exception Teaching Physician Rules for Surgical Procedures Telephone Calls Time Based Codes Welcome to Medicare Wellness Visits (Personal Prevention Plan Services Guide to Acronyms Index