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

Resource ordered for the Health Information Technology program 105301.

When it comes to clinical documentation, physician advisors have a range of important responsibilities, from query escalation to denials management and everything in between. With all these tasks on their plate, physician advisors are constantly pulled in different directions, making it hard to make the best use of their time. CDI Companion for Physician Advisors: Notes From the Field is designed to help physician advisors structure their time properly and carry out their CDI duties effectively and efficiently. This book will help physician advisors: Find their feet in the CDI role Identify tools to provide effective documentation education for physicians and CDI staff Engage medical staff in documentation improvement efforts Understand common documentation deficiencies for difficult diagnoses such as sepsis, heart failure, and kidney disease Work with their CDI team to tackle advanced record reviews in areas such as quality, audit defense, and outpatient HCCs Figure out how to best structure their time to carry out CDI duties

This codebook helps professionals remain compliant with annual CPT code set changes and is the AMAs official coding resource for procedural coding rules and guidelines. Designed to help improve CPT code competency and help professionals comply with current CPT code changes, it can help enable them to submit accurate procedural claims.

The RAC Toolkit for Hospitals and Health Systems: Manage Responses and Avoid Claims Under the Permanent Program Amanda W. Berglund, MS, MBA; Elizabeth E. Lamkin, MHA Learn how to respond to RAC audits. And more importantly, how to prevent them. The RAC Toolkit for Hospitals and Health Systems: Manage Responses and Avoid Claims Under the Permanent Program is your answer to turning plans into proactive action for RAC success. Authors Elizabeth E. Lamkin, MHA, and Amanda W. Berglund, MS, MBA, describe how to establish and sustain an effective RAC-preparedness structure that can be adapted to fit any organization's system. They provide best practices for successful processes and outline each staff member's role in your RAC audit program. Whether you are responding to a Recovery Auditor or another government auditor, your program must operate as effectively as possible. You will use their tested, proven, and practical tools that will help you build a more effective billing compliance program. You'll learn how to bring finance, business office and clinical staff together for operational improvements that directly affect your bottom line. The RAC Toolkit for Hospitals and Health Systems will help you get the job done right. The RAC Toolkit for Hospitals and Health Systems will help you achieve the following goals: Take a systemic approach to RAC compliance Incorporate effective structure and processes to existing systems for measurable results Organize committees and facilitate information flow Appeal effectively and within deadlines Use proven tools and methods for an effective RAC program Table of Contents: Chapter 1: RAC Program Overview Chapter 2: Preparing for RAC Chapter 3: The Right Structure: Organizing the Committees Chapter 4: The Right People: Three Critical Roles for RAC Prevention Chapter 5: Additional RAC Stakeholders Chapter 6: Automated Reviews Chapter 7: Complex Review and Extrapolation Chapter 8 The Appeal Appendix (Acronyms and additional resources) Take advantage of these valuable tools included in your book: RAC appeal timeline RAC preparedness checklist RAC committee structure flowchart Organizational chart for RAC-related personnel Sample RAC committee meeting agenda Sample UR committee meeting agenda Complex case review worksheet Admission review continued stay and discharge review flowchart Patient status change letter template Automated review timeline Complex review timeline Appeal letter template for appeal level 1 redetermination CMS form 20027 CMS form 20034 CMS form DAB101

This money saving package includes Step-by-Step Medical Coding, 2009 Edition - Text and Virtual Medical Office.

Updated with 2012 CPTr changes! Hospitals have long struggled under complicated guidelines for coding injection and infusion services. But those days are over. Now, using a simple coding decision tree as your guide, you can master coding for these common procedures without having to master complex coding guidelines. The Injections and Infusions Coding Toolkit was developed by the staff at The University of Texas MD Anderson Cancer Center, a high-volume and world-renowned cancer treatment facility in Houston, TX. They designed a tool that makes it easy for staff to capture correct codes at point-of-service -- or for coders to use to assign appropriate codes to bill. The toolkit takes the guesswork out of: * Selecting the initial service * Deciding which codes can be reported in combination with other codes Your toolkit is updated with 2012 CPT changes and includes everything you need to get started today, including: * 5 copies of the color-coded, laminated coding decision tree * 5 copies of pocket-sized "cheat sheets" to help identify frequently used codes * A CD-ROM with the coding tree files you can customize for your facility * A PDF training guide and a PowerPoint training presentation

Take your first step toward a successful career in medical coding with guidance from the most trusted name in coding education! The bestselling Buck’s Step-by-Step Medical Coding is a practical, easy-to-use resource that shows you exactly how to code using all current coding sets. To reinforce your understanding, practice exercises follow the explanations of each coding concept. In addition to coverage of reimbursement, ICD-10-CM, CPT, HCPCS, and inpatient coding, an Evolve website includes 30-day access to TruCode® Encoder Essentials. No other book so thoroughly covers all coding sets! Theory and practical review questions (located at the end of each chapter) focus on recalling important chapter information and application of codes. A step-by-step approach makes it easier for students to build coding skills and remember the material. Learning objective and glossary review questions reinforce student understanding of key chapter concepts and terms. 30-day trial to TruCode® Encoder Essentials gives students experience with using an encoder (plus access to additional encoder practice exercises on the Evolve website). UNIQUE! "Real-life" coding reports (cleared of any confidential information) simulate the reports students will encounter as coders, and help them apply coding principles to actual cases. Online activities on Evolve provide extra practice with assignments, including coding reports. More than 450 illustrations help in understanding the types of medical conditions and procedures being coded, and include examples taken directly from Elsevier's professional ICD-10 and HCPCS manuals. UNIQUE! Four coding-question variations — covering both single-code questions and multiple-code questions and scenarios — develop students’ coding ability and critical thinking skills. UNIQUE! Coders’ Index in the back of the book makes it easy to quickly locate specific codes. Official Guidelines for Coding and Reporting boxes show the official guidelines wording for inpatient and outpatient coding alongside in-text explanations. Exercises, Quick Checks, and Toolbox features reinforce coding rules and concepts, and emphasize key information. Valuable tips and advice are offered in features such as From the Trenches, Coding Shots, Stop!, Caution!, Check This Out, and CMS Rules. Sample EHR screenshots (in Appendix D) show examples similar to the electronic health records students will encounter in the workplace. NEW! Coding updates include the latest information available, promoting accurate coding and success on the job. NEW! Coverage of CPT E/M Guidelines changes for Office and Other Outpatient codes.

A must-have resource for CPT Professional users! This annual title, serves as a reference tool to understanding each of the CPT code changes found in CPT RM 2003. Every new, revised or deleted code change is listed along with a detailed rationale for the change. Guideline changes are also explained.