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Create Your Own Medical Necessity Quick Reference Tool

If you want to keep denials and compliance problems at bay, your claims must support medical necessity.
So retrofit your own, customized medical necessity quick power-reference tool with these tips from Sandy Nicholson, who taught some classes at the recent E/M Coding & Billing Conference in Orlando.
Step 1: Identify services which you provide for which CMS […]

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Spinal Surgery Coding Challenge: Is Hemilaminectomy Bundled With Fusion?

Question: Our orthopedic surgeon turned in a note that says, “Performed a bilateral hemilaminectomy with discectomy and foraminotomy for nerve decompression.Then I did a lumbar decompression with posterior lumbar interbody fusion and posterior lateral transverse fusion with pedicular screws.”
How should I report this? Is the hemilaminectomy bundled with the fusion?
Answer: No, you shouldn’t consider the […]

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Conquer In-Office Coumadin Coding, Easy as 1-2-3

Tip: Watch how you support medical necessity for warfarin therapy. Here’s where many coders make the wrong ICD-9 choice.
Don’t get stuck with the bill for your physician’s in-office monitoring of Coumadin use — instead, learn the Coumadin coding ropes. One surefire way is to follow these 3 guidelines.
1. Put Proper Code to Periodic PT Test
“Physicians often use […]

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