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JOURNAL Brought to you by the Medical Management Institute | Feb/March 2014 | Issue 2 Volume 5
Highlights MMI News Updates CMS News Updates
ICD-10: DELAYED AGAIN Spotlight on Modifier 77 2014 Book Deals MMI Check-Up for ICD-10 Obamacare...What Do You Think? HIPAA Compliance Courses February/March Crossword Puzzle
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Hands-On ICD-10 Training - Join Us! Learn the new coding language that is ICD-10-CM through a practical, hands-on course that will give you and your office the building blocks to ensure future fluency with the new coding requirements. When: Friday, June 6, 2014 Where: Alpharetta, GA
MMI News Updates CMS News Updates
Early bird registration discounts are available. Check out page 10 of this issue for details on the price cuts, information on the instructor, and directions on how to RSVP. For additional information visit mmi-classes.com/icd10event. We hope to see you there!
Spotlight on Modifier 77 2014 Book Deals MMI Check-Up for ICD-10
Have You Used Your MMI Holiday Gift Card? The MMI Holiday Gift Card was mailed out at the end of last year to all of our valued members & active students. This gift card contained two promo codes to give you an exclusive discount on MMI’s CEU courses & certification training (including ICD-10). The card expires June 1, 2014.
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ICD-10: DELAYED AGAIN
Didn’t receive the gift card? Email info@mmiclasses.com to be emailed the e-copy today.
Obamacare...What Do You Think?
ICD-10 is Delayed...Again! The US Senate voted on the SGR fix on March 31st, that included language delaying ICD-10-CM/PCS implementation. The votes are in, and ICD-10 has been delayed again until October 2015.
HIPAA Compliance Courses
What does this mean for you? If you have already trained for the ICD-10 transition, this means you are ahead of the game and now have time to practice and refresh when the time does come.
Feb/March Crossword Puzzle
If you are enrolled in any of MMI’s ICD-10 training programs, then you will still have access to the training until the official implementation date (October 2015 or beyond).
MBJ BY THE MEDICAL MANAGEMENT INSTITUTE
cms•updates Direct Resource: www.cms.gov H E A LT H P O L I C Y S TA N D A R D S
March 5, 2014 - The Department of Health and Human Services (HHS) is releasing key standards for health insurers and the Health Insurance Marketplace for 2015, ensuring that consumers have multiple health insurance coverage options, that states continue to have flexibility in their markets, and that issuers and employers have the early guidance and certainty they need to provide affordable health coverage next year. “These policies implement the health care law in a commonsense way by continuing to smooth the transition for consumers and stakeholders and fixing problems wherever the law provides flexibility,” said HHS Secretary Kathleen S e b e l i u s . “This comprehensive guidance will help ensure that consumers, employers and insurers have the information they need to plan for next year and make it easier for families to make decisions to access quality, affordable coverage.” QUALITY MEASURES ADDED TO P H Y S I C I A N C O M PA R E
February 21, 2014 - The Centers for Medicare & Medicaid Services (CMS) announced that for the first time, quality measures have been added to Physician Compare, a website that helps consumers search for information about hundreds of thousands of physicians and other health care professionals. The site helps consumers make informed choices about their care. “Patients and their families need facts to help them in making important decisions about health care, and choosing the right physician is one of the most important decisions they face,” said CMS Administrator Marilyn Tavenner.
In the first year, 66 group practices and 141 Accountable Care Organizations (ACO) now have quality data publicly reported on Physician Compare. The data are reported at the group practice and ACO level. A C C E S S T O C L I N I C A L L A B O R AT O R Y T E S T R E S U LT S
February 3, 2014 - As part of an ongoing effort to empower patients to be informed partners with their health care providers, the Department of Health and Human Services (HHS) has taken action to give patients or a person designated by the patient a means of direct access to the patient’s completed laboratory test reports. H E A LT H I N T E G R AT I O N PROJECT
January 30, 2014- The Centers for Medicare & Medicaid Services (CMS) announced a request for applications for the Frontier Community Health Integration Project. In collaboration with the Federal Office of Rural Health Policy in the Health Resources and Services Administration (HRSA), this initiative aims to develop and test new models of integrated, coordinated health care in the most sparsely populated rural counties with the goal of improving health outcomes and reducing Medicare expenditures. GEOGRAPHIC AREAS ADDED
January 30, 2013 - New temporary moratoria on the enrollment of home health agencies in four metropolitan areas (Fort Lauderdale, Detroit, Dallas and Houston). This new temporary moratoria also includes the enrollment of new ground ambulance suppliers in the Greater Philadelphia area.
MBJ BY THE MEDICAL MANAGEMENT INSTITUTE
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MMI 2014 Book Bundle Deals Range from $99-$279
The Medical Management Institute code books through Optum, AMA, (MMI) offers books for all of your & Mag Mutual. medical coding, medical billing, medical auditing, and medical management needs. Can’t find what you are looking for? Please let us know and we can We hope to provide those in the try and get it for you. health care industry with effective and efficient resources by carrying Email info@mmiclasses.com the most current CPT®, HCPCS Call 866-892-2765 Level II, ICD-9-CM, and ICD-10-CM
>>Check out 2014 Book Deals 24
MBJ BY THE MEDICAL MANAGEMENT INSTITUTE
February/March
MMI Check-Up for ICD-10 ICD-10 Exercises & Scenarios | Monthly Feature MMI will provide coding exercises and scenarios each month in the MBJ so that you can verify your progress in understanding and coding ICD-10. You will need an ICD-10 manual to complete the exercise, so if you have not already, sign up for our ICD-10 curriculum. MMI’s ICD-10 Check-Ups are posted on the MMI Blog as well! Scenario 1
Answers:
Dr. Hilton is covering for Dr. Myers while he is sick and out for the week. Each physician is a solo practitioner and often covers for the other for vacations, sick leave, etc.
Scenario 1:
A patient of record for Dr. Myers visits Dr. Hilton; this is the first time Dr. Hilton has seen this patient. The 9-yearold girl is complaining of right ankle pain after falling during a school basketball game. Dr. Hilton notes that the ankle is swollen and tender to touch and the girl is obviously having trouble putting weight on it. After performing an expanded problem-focused history and exam, Dr. Hilton orders the patient to take children's ibuprofen for pain, use ice compression to the affected area to reduce swelling, and prop the foot up and avoid full weight-bearing activities including basketball for at least 72 hours. Dr. Hilton also wraps the ankle with elastic bandage and advises the patient to follow up with Dr. Myers. What procedure and diagnoses would you use to code this encounter?
Coding Practice Code the following diagnoses in ICD-10:
1. Normal delivery of single live-‐born 2. Bilateral chronic serous otitis media 3. Postoperative pneumothorax 4. Spina biAida lumbar region 5. Acute angle-‐closure glaucoma right eye 6. Fever with chills 7. Rheumatoid arthritis of left wrist 8. Obsessive-‐compulsive neurosis 9. Chest pain on breathing 10. High cholesterol
Procedure: 99213 Established Patient Diagnosis: S99.811A, Y93.67, Y92.211 Although Dr. Hilton is seeing the patient for the first time, the CPT guidelines clearly state that, "in the instance where a physician is on call for or covering for another physician, the patient's encounter will be classified as it would have been by the physician who is not available." Therefore, since the patient is a "patient of record," which would indicate an established patient of Dr. Myers, the encounter must be coded as an established patient for Dr. Hilton. The scenario above indicated the right ankle pain after falling during a school basketball game. Coding the diagnoses for the above would be “right ankle pain (S99.811A), activity involved is basketball (Y93.67), and based on the child’s age, it would be would be elementary school (Y92.211.) Coding Practice
1. O80.0 – Encounter for full-‐term uncomplicated deliver) NOTE use additional code to indicate outcome of delivery Z37.0 – Single live birth 2. H65.23 – Chronic serous otitis media 3. J95.811 – Postprocedural pneumothorax 4. Q05.7 – Lumbar spina biMida without hydrocephalus 5. H40.211 – Acute angle-‐closure glaucoma, right eye 6. R50.9 – Fever, unspeciMied, Fever with chills 7. M05.632 – Rheumatoid arthritis of with involvement of other organs and systems 8. F42 – Obsessive-‐compulsive disorder 9. R07.1 – Chest pain on breathing, Painful respiration 10. E78.0 – Pure hypercholesterolemia
MBJ BY THE MEDICAL MANAGEMENT INSTITUTE
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Obamacare. What Do You Think? By Janet Salyer with Insurance Planning Solutions The Patient Protection and Affordable Care Act is one of the most controversial laws that passed in recent years. The PPACA, or ACA, or as it is commonly called “Obamacare”, was signed into law in March, 2010. The extensive implementation of the new law began September, 2010, a short four months later. The implementation of the law has been plagued by technical difficulties, challenges and court cases. Many government officials, politicians, news reporters and analysts have different opinions about the law.
But what do you think? Some of the provisions discussed in this article are familiar, some may not be. I hope this article encourages you to learn more about the specifics of the law and to decide for yourself if this is a good provision of the law or not so good provision of the law. First, let’s take a look at the implementation of any bill. Once the bill is signed into law, the bill is
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reviewed and compared to laws that are currently in force. This process takes time and usually involves multiple government agencies Then, regulations for implementation of parts of the law are released. It’s the regulations that give the details that are guidelines for those impacted by the law such as doctors, employers and insurance companies. Once the regulations are written, they are posted for comments and may be revised based on the feedback. Then the final regulations are issued. If the points of the bill are deemed difficult or not feasible to implement, a “safe harbor” ruling may be made for the implementation of that point of the law, or Congress may pass amendments to specific parts of the new law. Let’s look at another law, HR6983, which is the Mental Health Parity and Addiction Act of 2008. The bill was a short 36 pages long and was passed September 23, 2008. The bill called for the law to go into effect October 3, 2009; the interim final regulations were released February 2010; and the
Department of Labor FINAL regulations were filed November 2013. That final regulation is 206 pages long. The Treasury Department, the US Department of Labor, and the U.S. Department of Health and Human Services (HHS) were all involved in the writing and implementation of the mental health parity regulations. The Employee Retirement and Security Act – commonly called ERISA – is one of many laws updated because of the mental health parity act. Compare that mental health parity bill to the Patient Protection and Affordable Care Act with the 2409 pages of the original bill plus the reconciliation in the House and the reconciliation in the Senate. The bill affects so many industries and has so many provisions. Regulations are still being written and released. The implementation of some provisions began before interim regulations could be released. It is my opinion that the ACA implementation timeline was too aggressive from the beginning. I believe that a many technical difficulties and many implementation costs could have been avoided if the people who write the regulations had been given more time to do their job properly. Let’s look at a few of the provisions of the ACA. The ACA encourages the creation and use of HMO networks. Health Maintenance Organizations (HMO’s) utilize a primary care physician (PCP) to coordinate care for the patient. Patients first see a PCP who refers them to a specialist if he or she cannot resolve the medical issue. In the past, PCP’s were often referred to as “gatekeepers” because the PCP kept patients from over-utilizing the healthcare system and therefore kept costs down. Another feature of HMO networks is that patients who see providers not participating in the network must pay the full amount of the cost of their care – out of network care is not covered by an HMO insurance plan. The ACA calls the PCP a “care coordinator” and encourages each person, whether in an HMO, POS or PPO network, to name a PCP who is responsible for tracking the care the patient receives.
What do you think? Should insurance companies, or hospitals, or other organizations create HMO’s that require referrals before patients see specialists such as cardiologists? Should we no longer offer Preferred Provider Organizations (PPO)networks, Point of Service (POS) networks and other networks that allow patients to decide when to see a specialist and provide out of network benefits? The ACA makes it illegal for doctor’s to own a hospital because it is considered a conflict of interest. Those doctors who already own hospitals are allowed to keep them, but no new hospital purchases or investments in hospitals are allowed. Today, hospitals are purchasing private practices--
the law does not comment on hospitals owning doctors’ practices or in hospitals selling their own health insurance plans.
What do you think? Is it also a conflict of interest for hospitals to “own” doctor’s practices or sell insurance policies? The launch of the Federally Facilitated insurance Marketplace (FFM) and State/Federal Partnership insurance Marketplaces has been rocky at best. In addition to the technical difficulties, each insurance company operating in a state can choose by “community” or county to participate on the marketplace or to only offer plans off the marketplace. This means that those who apply on the marketplace have fewer options for their coverage than those who apply off the marketplace. Is a marketplace really necessary? Prior to the ACA and the creating of the “marketplace”, there were many options for comparing plans and premiums between insurance companies.
What do you think? Should the government have invested millions of dollars to create a website? Should the government spend millions of dollars to promote a website for the sale of health insurance? Should the Federal Government be advertising on TV, radio, Twitter, and Facebook? The ACA established “advanced premium tax credits” to assist those who qualify with their insurance premiums. Households with incomes between 100% and 400% of the Federal Poverty Level (FPL) may be eligible for the “advanced premium tax credits”. The premium tax credits are only available if you apply through the marketplace. The premiums for plans on and off the marketplace are the same, so there’s no difference in pricing.
What do you think? Should these tax credits only be available if you apply through the marketplace? Shouldn’t everyone who is qualified for premium tax credits be allowed to purchase plans through any means available to them – on or off the marketplace- and still get the premium tax credits? The ACA called for expansion of state run Medicaid programs. The Supreme Court ruled this part of the ACA is unconstitutional and that the Federal Government cannot force states to expand Medicaid. The ACA has not yet been amended to reflect this ruling. The ACA calls for households making between 100% and 400% of the Federal Poverty Level (FPL) to receive premium tax credits. By law,
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those that make less than 100% of the FPL are not eligible for advanced premium tax credits. Also, the ACA only asks about income, not about assets the household owns. Many State Medicaid programs do consider assets when determining if an individual is eligible for Medicaid. The result is that some of the lower income people are not eligible for Medicaid and are not eligible for premium tax credits. On the flip side, some individual with significant cash assets are eligible for premium tax credits.
What do you think? Should the ACA requirements reflect the Medicaid eligibility requirements of each state? Should the ACA also consider assets when determining if a household is eligible for premium tax credits? The ACA considers a fair premium for health insurance to be 9.5% of the individual’s or household’s income. For an individual, that’s box 1 of the W2. According the ACA, the fair premium is 9.5% of your gross earnings.
What do you think? Is that a fair price for major medical health insurance premiums? The Supreme Court ruled that the Affordable Care Act (ACA) mandate requiring everyone to purchase health insurance is constitutional because the penalty for not purchasing insurance is a type of tax. Congress has the authority to levy a tax. So, if the purchase of health insurance is a type of tax, why are some premiums paid with pre-tax dollars and some are not? The Model Notice for the Marketplace states that “…your employee contribution to employeroffered coverage - is often excluded from income for Federal and State income tax purposes.Your payments for coverage through the Marketplace are made on an after-tax basis.”
What do you think? If the mandate to purchase insurance is constitutional because it’s a type of tax, shouldn’t the ALL major medical health insurance premiums be made on a pre-tax basis? Why do those purchasing individual/family policies have to pay tax on the premium dollars? The ACA creates an “open enrollment period” for the purchase of individual/family (not group) insurance. The initial enrollment period began October 1, 2013, and is scheduled to end March 31, 2014. After the open enrollment period ends, only those with a qualifying event will be allowed to purchase individual/family major medical health insurance
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until the next open enrollment period. Those who have a “special enrollment period” will be allowed to purchase individual/family plan during the 63 days following their qualifying event. The next open enrollment period is scheduled for November 15, 2014, through January 15, 2015.
What do you think? Should there be an open enrollment period? Or should anyone wanting to purchase insurance be allowed to do so when they want to purchase it? Should the individual/family open enrollment period be the same time frame as the Medicare Open Enrollment period as it is now? Should the open enrollment period be during the end of the year holiday season when many government offices are closed and most families have very busy schedules? The ACA requires that insurance companies must cover pre-existing conditions and that they cannot charge a person more based on pre-existing health conditions. But, the ACA allows up to 50% additional premiums for the use of tobacco.
What do you think? Should people who use tobacco have to pay more for their insurance while everyone else cannot be charged extra? Will this provision allow Congress to add other “bad” habits to the list in the future so that more people will have to pay more for their insurance premiums? Do you know that while insurance companies cannot charge extra to unhealthy members, EMPLOYERS can. Employers who offer wellness programs can charge employees who don’t participate in those wellness programs extra for their employee health benefits?
What do you think? Should employers be responsible for promoting healthy habits and wellness programs at work?
Let us know. The ACA implementation continues until 2018. We have already seen more than 20 changes to the law, and I’m sure we will see more changes and more court cases as the implementation continues. I hope that you are all more curious and are encouraged to learn more about the implementation of the ACA. There are many more points to the law that could be mentioned here. I invite you to share your thoughts about details not mentioned in this article about the ACA & its implementation on Facebook.com/mmifan and Twitter.com/mmiclasses.
MBJ BY THE MEDICAL MANAGEMENT INSTITUTE
Insurance Planning Solutions Specializing in Individual & Small Group Benefits “We believe that QUALITY SERVICE to our clients is our highest priority�
What we offer: Coverage for small businesses and individuals/families.
We believe each individual, family, employer, and group has their own unique requirements and our job is to find the product, price, and quality plans with coverage that best fits those unique requirements. We believe that honesty, integrity, and professionalism are the foundation for our relationship with our clients.
Why use a broker? Licensed by the state of Georgia, the brokers must stay current in federal and state laws. They are also appointed by insurance companies, having the ability to compare policies from different companies. Ready to review your insurance coverage? For free quotes, contact Janet Salyer at 678-880-7098, or email jsalyer@insuranceplanningsolutions.com.
For details visit mmi-classes.com/online-hipaa
Early Bird March Pricing: $319 // $399 with ICD-10-CM Book
ICD-10-CM: Preparing You & Your Practice Live, Hands-On Training Learn the new coding language that is ICD-10-CM. This practical, hands-on training event will give you and your office the building blocks to ensure future fluency with the new coding requirements prior to October 1, 2014. consulting and education company in Saint Mary’s, Georgia. As a consultant, she has conducted hundreds of onsite physician audits to assess compliance risk, determine financial stability, and perform practice assessments. Additionally, with a health care administration degree, she has experience as a practice administrator in all aspects of practice management, running a start-up practice and developing operational improvements.
About the Instructor This live ICD-10 training event will be hosted by Mary Kustermann, RMM, RMC, CPC, CPC-H. Ms. Kustermann is a healthcare consultant and an AHIMA approved ICD-10 trainer. Currently, Ms. Kustermann is the owner of Advanced Health Resources, a medical
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Ms. Kustermann has given presentations nationally for the past five years on such topics as Medicare Rules and Regulations, Evaluation and Management Chart Auditing, Coding and Specialty classes, and she currently teaches the“bootcamps” for coding certifications for the nationally recognized American Academy of Professional Coders (AAPC) and the Association of Registered Health Care Professionals (ARHCP).
RSVP to Join Us: mmi-classes.com/icd10-event // 866-892-2765
Who Should Attend Coding & Billing Personnel Medical Records Personnel Clinical Staff Providers
W h a t W i l l Yo u L e a r n How maternal and infant records and claims must be separate Proper sequencing of complications associated with malignancies The 4 scale rating of asthma severity Required coma scale when coding a trauma When to report medication under dosing How to properly report acute MIs as STEM/NSTEMI, and the additional requirements for 4 weeks after an infarction versus 8 The 5 categories of diabetes New coding for accidents, poisonings, burns and complications How to code “sepsis and causal relationships” Correct coding for combination diabetes mellitus and its complications Guidelines for coding pain, i.e., postoperative pain, pain associated with neoplasms, and chronic pain syndrome Guidelines in coding pressure ulcers and why documentation must reflect the stage of ulcer How to code for deliveries, and learn why the ICD-10 separates out the maternal record and corresponding coding from the newborn record and coding
W h e n : June 6, 2014 (Friday) W h e r e : Preston Ridge Medical Campus 3330 Preston Ridge Rd, Alpharetta, GA 30005
Hotels Near Preston Ridge Studio Plus Deluxe Studios - Atlanta - Alpharetta - Northpoint (.02 miles away) 3331 Old Milton Pkwy Alpharetta, GA 30005 770-475-7871 www.studioplus.com Staybridge Suites (.04 miles away) 3980 North Point Pkwy Alpharetta, GA 30022 888-299-2208 www.staybridge.com Hyatt Place Atlanta/Alpharetta/Windward Parkway (1 mile away) 5595 Windward Pkwy Alpharetta, GA 30004 770-343-9566 www.place.hyatt.com
Holiday Inn Express 2950 Mansell Road Alpharetta, GA 30022 770-552-0006 www.holidayinnalpharetta.com
RSVP to Join Us: mmi-classes.com/icd10-event // 866-892-2765
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SPOTLIGHT ON MODIFIER 77 Modifier of the Month | Monthly Feature
77 is used to report a repeat procedure or service by another physician or QHCP.
Each month in the MBJ, we will feature a modifier and discuss the appropriate use. So far we have reviewed Modifiers 24, 25, 26, 57 & 76, so this month we will take a look at Modifier 77. First let’s look at the definition and use.
Modifier 77 Modifier 77 is used to report a “repeat procedure or service by another physician or other qualified health care professional.� Last month, we covered the use of modifier 76, which is used to report a repeat service by the same physician. The use of modifier 77 is relatively similar to that of modifier 76, with the exception that repeat service is conducted by another physician at a different session from the initial service. To avoid duplicate billing, the use of modifier 77 distinguishes the two different encounters between the two physicians for the same service, on the same day.
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Most payers recognize modifiers 76 & 77 for coding labs and radiological services, but surgical codes are also notable for modifier usage. This modifier should not be reported to an E/M service.
Use of Modifier 77 There are cases when you are not sure who ordered the second procedure, or if the same physician ordered both procedures. When this is the case, code based on the physician who performed the procedure. Append modifier 77 based on the physician who actually performed the repeated service.
Example A patient who has a history of wheezing and coughing went to his primary care physician, Dr. Anderson, early in the morning. Dr. Anderson did a chest x-ray and revealed a small, unusual mass. He referred the patient to see pulmonologist specialist, Dr. Craig.
MBJ BY THE MEDICAL MANAGEMENT INSTITUTE
SPOTLIGHT ON MODIFIER 77
The patient went to Dr. Craig later that day, where he also did a chest x-ray. Due to the original film not being quite clear, he requested an additional film. • Both physicians must document their own work. • Since both physicians performed the x-ray, they would both bill the same CPT code: 71020. • However, the second physician (Pulmonologist Dr. Crag) would append a 77 modifier to the xray code 71020-77 to let the payer know that he had also provided the same exact service to avoid denial of claim payment.
Appropriate Usage of Modifier 77 • The repeat service must be identical to the initial service provided by the different physician at the different encounter. It must be the same procedure code. • Example: Patient had surgery by Dr. A. The result was unsuccessful. Dr. B performed the same procedure three weeks later. • To report the same procedure performed more than once, on the same date of service, by a different physician and at different encounters. • Example: Procedure in AM by Dr. A, then the exact same procedure is done later in PM by Dr. B. • To report the professional component of an xray or EKG when the patient has had two or more tests and more than one physician provided the interpretation and report. • To report the professional component of an xray or EKG when a different physician repeated the reading than the physician performing the initial interpretation.
Let’s Put Modifier 77 to Use: Scenario 1 Katy, a 16 year-old girl, was hiking in the woods over the weekend. She tripped over a rock and fell. She caught herself from full impact with her hands. Immediately, she felt sharp pain and noticed some bruising to her right wrist. At the urgent care down the street, an x-ray was taken but they did not have a radiologist, so she brought the films to her Primary Care Physician later that day. Dr. Ray, her PCP, saw the film but it was not clear, so he took another x-ray. From his film, he was able to assess Katy’s wrist. • Since Dr. Ray had to take another x-ray from the urgent care, he would code his x-ray as: 73100-77 Scenario 2 Dr. Quincy, a well-known New York surgeon, performed a tibial osteotomy surgery on a patient at Webster Hospital. Dr. Larry, a local surgeon in the Small County Hospital, had performed the procedure two weeks ago, but was unsuccessful. Therefore, Dr. Quincy, with his expertise in this type of surgery, was brought in to perform the same surgery with no pre/post operative care of the patient. • There are multiple modifiers to be used in this postoperative procedure, but we will focus only on the repeated surgical service. • For coding, Dr. Quincy performed the 2nd repeat procedure two weeks after Dr. Larry’s 1st surgery. The surgical code with repeated service modifier will be coded as 27448 -77. Be sure to use best practice coding to avoid unnecessary re-billing and frustrating duplicate denials. Documentation is of utmost important in medical records to support any unusual, medically necessary services. As always, know your payer’s policy and guidelines when coding modifier 77 and other procedures.
MBJ BY THE MEDICAL MANAGEMENT INSTITUTE
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Should you become a
Registered Medical Coder?
✴
What is a RMC? The RMC certification proves
✴
Who is the RMC intended for? The RMC
Average RMC Salary*
✴ ✴ Completely Online
✴
that you know how to assign the correct diagnosis (ICD-9-CM), procedure (CPT®) and supply (HCPCS Level II) codes in a physician-office setting.
certification is intended for physician-office based coders & billers. The certification exam is administered online, so it is ideal for full-time working coders & billers as well as those looking to work from home as a remote coder.
Completely Online. The certification exam is administered online through the Medical Management Institute (MMI), making it an ideal credential for full-time coders & billers and those looking to work from home as a remote medical coder.
Average Salary: $48,696* The average annual salary for the Registered Medical Coder (RMC) is $48,696, versus $39,374 for a Certified Professional Coder (CPC®) and $41,681 for a Certified Coding Specialist-Physician-Based (CCS-P).
Authorized Credential. The RMC certification exam is administered through the Medical Management Institute (MMI), and adheres to the strict guidelines of the state of Georgia Nonpublic Postsecondary Education Commission (NPEC).
*Sa la ry stats p u T h e M ed ical M an ag em en t In st it u te (M M I) is th e ed u ca ti o n al le ad er in m ed ical b ill in g & co d in g , au d it in g & m an ag em en t trai n in g . M M I is re g iste re d & ad h eres to th e st ri ct g u id el in es o f th e state o f G A N o n p u b lic Po stse co n d ary E d u ca ti o n Co m m issi o n (N P E C ).
Who is MMI?
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RMC Benefits • In crea se d a n n u
a l sa la ry * • O n li n e -b a se d ce rt ifi ca ti o n & re newal • M M I membe rs h ip is in cl u d e d : fu ll -i n su p p o rt , jo b st ru ct o r & n e tw o rk in g o p p o rt u n it ie s a cce ss to th e and M e d ica l B u si n e ss Jo u rn a ls , m o n th ly e -n e M M I’s w sl e tte r fu ll o f co d in g u p e x cl u si v e d is co d a te s, u n ts , a n d h e lp fu l re so u rce s.
Learn more a t
MMI-classes.c om/RMC
Should you become a
Registered Medical Manager?
✴
What is a RMM? The RMM certification
✴
Who is the RMM intended for? The RMM
✴
Completely Online. The certification exam is
✴
Authorized Credential. The RMM
Advance Your Career
Completely Online
T h e M ed ical M an ag em en t In st it u te (M M I) is th e ed u ca ti o n al le ad er in m ed ic al b ill in g & co d in g , au d it in g & m an ag em en t trai n in g . M M I is re g iste re d & ad h eres to th e st ri ct g u id el in es o f th e state o f G A N o n p u b lic Po stse co n d ary E d u ca ti o n Co m m issi o n (N P E C ).
Who is MMI?
proves that you are more than capable of holding a leadership and/or management position in a medical office setting.
certification is intended for physician-office based coders & billers looking to advance their careers as well as those looking to become a practice manager, business office administrator, or medical office staff member. The certification exam is administered online, so it is ideal for fulltime working professionals as well as those looking to join the field.
administered completely online through the Medical Management Institute (MMI).
certification exam is administered through the Medical Management Institute (MMI), and adheres to the strict guidelines of the state of Georgia Nonpublic Postsecondary Education Commission (NPEC).
RMM Benefits • O n li n e -b a se d ce
rt ifi ca ti o n & re newal • M M I membe rs h ip is in cl u d e d : fu ll -i n su p p o rt , jo b st ru ct o r & n e tw o rk in g o p p o rt u n it a cce ss to th e ie s and M e d ica l B u si n e ss Jo u rn a ls , m o n th ly e -n M M I’s e w sl e tt e r fu ll of new s up e x cl u si v e d is co d a te s, u n ts , a n d h e lp fu l re so u rce s.
Learn more a t
MMI-classes.c om/RMM
FEBRUARY/MARCH CROSSWORD We hope you enjoyed this issue‌ now test your knowledge!
Across 7. The live, hands-on ICD-10-CM training event will be presented by this AHIMA approved ICD-10 trainer. 9. The next free ICD-10 Lunch & Learn event will be held on this date.
Down 1. This is what HMO stands for, which are used to utilize a PCP to coordinate care for the patient. 2. Janet Salyer, author of the "Obamacare...What Do You Think?" article on pg. 6, works for this company. 3. The Patient Protection & Affordable Care Act is commonly called this nickname. 4. The MMI Holiday Gift Card will expire on this date. 5. The live, hands-on ICD-10-CM training event will be held on this date. 6. CMS announced that for the first time, ____ _____ have been added to Physician Compare. 8. Modifier __ is used to report a repeat service by the same physician.
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MBJ BY THE MEDICAL MANAGEMENT INSTITUTE
THE MEDICAL BUSINESS JOURNAL BROUGHT TO YOU BY THE MEDICAL MANAGEMENT INSTITUTE The Medical Business Journal is a monthly source of up-to-date information on all issues affecting the healthcare industry. Its content ranges from medical coding and billing to healthcare reform legislature and beyond. The MBJ is not affiliated in any way with the Department of Health and Human Services, Medicare, or the Centers for Medicare and Medicaid Services. This publication is designed to provide accurate and authoritative information with regard to the subject matter covered. It is sold with the understanding that the publisher is not engaged in rendering legal, accounting or other professional services, and is not a substitute for individualized expert assistance. The CPTÂŽ codes, descriptors, and modifiers are copyrighted by the American Medical Association. For more information, please call MMI at 866-892-2765.
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Issue 2, Vol 5
Editor in Chief Carleigh Benscoter
Contributors Janet Salyer Loan Tran Carleigh Benscoter
Layout & Design Carleigh Benscoter
866-892-2765
Link List [Issue 2, Vol 5] 2014 Books: http://www.mmi-classes.com/blogs/mmi/9948897-day-of-thanks-on-november-19th-save-the-date, 2014 ICD-10 Official Draft Set: http://www.mmi-classes.com/collections/2014-medical-coding-books/products/2014-icd-10draft, ICD-10 Online Certification Training: http://www.mmi-classes.com/pages/icd-10-online-certification-training, ICD-10 Blog: http://www.mmi-classes.com/blogs/mmi-check-up-for-icd-10, Live, Hands-On ICD-10 Training: http:// www.mmi-classes.com/icd10-event
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