Medical Coding Simplified

In countries like the US, citizens are investing in health insurance plans, which are directly increasing the demand for medical coders’. Recently got an opportunity to interact with a few life sciences students. That is when I asked a student who seemed keen about getting into the pharma industry: “What if you don’t get your desired job profile”? This question actually was a bolt from the blue as he was baffled and realized he didn’t have a plan B. Every year, a large number of science students pass out with an ambition to become a nurse, a doctor, a pharmacist or a medical professional. While only a few get to achieve their goals, many life sciences graduates are unable to decide on an alternate career option. There is nothing to get worried about as the healthcare sector provides plenty of other options, but not many take these. While there might be various reasons for this, the primary factor is a lack of awareness the many prospects that are present in this field. ...

The letter " x ” serves as a placeholder when a code contains fewer than six characters and a seventh character applies. The " x ” also allows for future expansion of the codes. When reporting ICD - 10 - CM codes, coders must add a placeholder so the seventh character is in the correct position. Not every ICD-10-CM code with a seventh character has a sixth character—or even a fifth or fourth character for that matter. This frequently occurs with poisonings and injuries. The letter "x” serves as a placeholder when a code contains fewer than six characters and a seventh character applies. The "x” also allows for future expansion of the codes. When reporting ICD-10-CM codes, coders must add a placeholder so the seventh character is in the correct position. Without this placeholder to ensure characters appear in the correct positions, codes are invalid. For example, a patient presents with an accidental poisoning by an antiallergic drug. For the initial ...

It’s every physician’s worst nightmare: Receive payment for services rendered, but then a payer identifies an aberrant pattern in claims data, audits the records, decides it has overpaid the practice, and recoups those funds. That money you already allocated for overhead, staff salaries, bonuses, or new medical equipment? Gone. With one post-payment audit, you now owe thousands of dollars or more. The good news is, physicians can take steps to focus on accurate billing and avoid costly recoupments. This article explores five billing vulnerabilities and provides tips to maintain compliance. E/M coding: Four tips to select the correct level Payers don’t usually deny evaluation and management (E/M) codes on the front end, says Toni Elhoms, CCS, CPC, a provider coding and education consultant in Denver. It isn’t until they look at the totality of the data retrospectively—long after physicians are paid—that financial penalties ensue, she adds. “Payers are like the IRS,” says ...