HCC Blog by Caridad

"Provider Outreach and Education (POE) team members educate Medicare providers about the fundamentals of the Medicare program; national and local policies and procedures; new Medicare initiatives; and any significant changes to the Medicare program. Noridian offers a variety of strategies and methods to distribute information about the Medicare program to our provider community."  Noridian Education Choices include: Web based workshops: direct link, click here #HCC #ICD10 #CMS #ICD9 #RiskAdjustment #MedicalCoding   Disclaimer : This guidance is to be used for an easy reference; the ICD-9-CM and ICD-10-CM code books and the Official Guidelines for Coding and Reporting are the authoritative references for accurate and complete coding. This blog may contain references or links to statutes, regulations, or other policy materials. It is not intended to take the place of either the written law or regulations.   The information presented herein is for gener...

What are the compoments of a Welcome to Medicare Visit? The following explaination is from Palmetto found at: http://www.palmettogba.com/palmetto/providers.nsf/DocsCat/Railroad-Medicare~9LSQMA2210 Initial Preventive Physical Examination (IPPE) or Welcome to Medicare Preventive Visit The Initial Preventive Physical Examination (IPPE) is also known as the 'Welcome to Medicare Preventive Visit.' The goals of the IPPE are health promotion and disease prevention and detection. This document explains the components included in the IPPE. You must provide, or provide and refer, all components of the IPPE prior to submitting a claim for the IPPE. The Initial preventive physical examination; face-to-face visit services are limited to the new beneficiary during the first 12 the months of Medicare enrollment (G0402-Initial preventive physical examination). The IPPE contains Seven Components : Review of the individual's: Medical and social history with attention to modifiab...

From the Thursday, May 21, 2015 MLN Connects Provider eNews from Medicare Learning Network Medicare Learning Network ® Educational Products “Chronic Care Management (CCM) Services Frequently Asked Questions (FAQs)” MLN Matters ® Article — Released MLN Matters ® Special Edition Article #SE1516 , “Chronic Care Management (CCM) Services Frequently Asked Questions (FAQs)” has been released and is now available in downloadable format. This article is designed to provide education on Medicare’s requirement for 24/7 access by individuals furnishing CCM services to the electronic care plan, rather than the entire medical record. It includes FAQs regarding billing CCM services to the Physician Fee Schedule (PFS) and Hospital Outpatient Prospective Payment System (OPPS) under CPT code 99490. “Power Mobility Pearls for the Practicing Physician” Web-Based Training Course — Released The “Power Mobility Pearls for the Practicing Physician” Web-Based Training Course (WBT) was relea...

Certified Risk Adjustment Coder (CRC ™ ) Certified Risk Adjustment Coder is a certification available from American Academy of Professional Coders (AAPC). The information says it covers a wide variety of clinical cases and services for risk adjustment models (e.g., Hierarchical Co-existing Conditions (HCC), Chronic Illness and Disability Payment Systems (CDPS), and Health & Human Services (HHS) Risk Adjustment.   Something to think about earning, but it is not necessary to work in risk adjustment coding. https://www.aapc.com/certification/crc-certified-risk-adjustment-coding.aspx         #HCC #ICD10 #CMS #ICD9 #RiskAdjustment #Career #MedicalCoding #Coding   Disclaimer: This guidance is to be used for an easy reference; the ICD-9-CM and ICD-10-CM code books and the Official Guidelines for Coding and Reporting are the authoritative references for accurate and complete coding. This blog may contain references or links to statut...

Many professional associations offer continuing education credit for successful completion of CMS’ Medicare Learning Network® courses.   The current information for each association can be found at this CMS website . The following just covers American Academy of Professional Coders (AAPC): AAPC (As of July 2009) For more information, visit the AAPC education page at http://www.aapc.com/medical-coding-education/index.aspx on the Internet. The following shows the length of the WBT in relation to the amount of CEUs AAPC will award as well as the corresponding index number: Less than 30 minutes: .5 CEU, Index# CMS06140727A Anything greater than 30 minutes and up to 60 minutes: 1 CEU, Index# CMS06140728A Anything greater than 60 minutes and up to 90 minutes: 1.5 CEU, Index# CMS06140729A Anything greater than 90 minutes and up to 120 minutes: 2 CEU, Index# CMS06140730A When submitting a CMS completed web-based training course to AAPC as part of your recertificat...

We often will see the physician document the patient’s condition with just the words “STABLE” or “AS ABOVE” on a chart note.   These words alone do not qualifty as a narrative documentation on that date of service about the condition. This is from the SCAN HCC UniversityAsk a Coder : I continuously have a doctor that puts ‘same’ in the diagnosis field of the EMR or he will put “same as x-ray findings” Is this allowable? If not, PLEASE help me to explain to him that it’s not. A. There is no diagnosis code for “same”—I think that’s the best information you can give the physician. Diagnosis coding (or procedural coding for that matter) is always based upon the narrative documentation on this date of service. The physician must provide a narrative diagnosis on this date of service, in order for coding to be done. The physician is placing you and your organization at risk in the event of an audit. I suggest that you enlist the assistance of your manager or better ...

This is the March 2015 MLN Catalog which contains information available through the CMS Medicare Learning Network®. "Medicare Learning Network® educational products and services are designed to help you better understand and increase your knowledge of CMS program and policy information.  There are various formats, including articles, booklets, fact sheets, podcasts, reference guides and web based training. https://www.cms.gov/Outreach-and-Education/Medicare-Learning-Network-MLN/MLNProducts/Downloads/MLNCatalog.pdf #HCC #ICD10 #CMS #ICD9 #RiskAdjustment #MedicalCoding Disclaimer : This guidance is to be used for an easy reference; the ICD-9-CM and ICD-10-CM code books and the Official Guidelines for Coding and Reporting are the authoritative references for accurate and complete coding. This blog may contain references or links to statutes, regulations, or other policy materials. It is not intended to take the place of either the written law or regu...