Search found 11 matches

by maryanne
Fri Apr 29, 2016 11:32 am
Forum: Medical Auditing Forum
Topic: Review of Systems documentation...Help!!!
Replies: 2
Views: 2725

Re: Review of Systems documentation...Help!!!

Thank you very much for your reply. I appreciate it greatly. This provider is a hospitalist and has excellent documentation skills. The complete ROS was warranted, and she did have pertinent positives and negatives in her history of present illness. My concern is the nitpicking over whether the term...
by maryanne
Wed Apr 27, 2016 2:33 pm
Forum: Medical Auditing Forum
Topic: Review of Systems documentation...Help!!!
Replies: 2
Views: 2725

Review of Systems documentation...Help!!!

Hi everyone, So this is really bothering me and I would like some clarification if anyone can spare a little time. We have an outside auditing company hired by my employer. On a recent audit review, the provider documented pertinent positive and negative ROS findings in the HPI. Under the heading of...
by maryanne
Fri Sep 25, 2015 12:27 pm
Forum: Weekly Tip Comments & Discussions
Topic: ICD-10 Challenge September 25, 2015
Replies: 2
Views: 13714

Re: ICD-10 Challenge September 25, 2015

S63.501A Unspecified sprain of the right wrist, initial encounter. However, I would further query the provider to see if we could garner a little more specificity - ie, sprain of carpal joint, radiocarpal joint, etc. Happy Friday everyone!
by maryanne
Wed May 06, 2015 6:54 pm
Forum: Medical Auditing Forum
Topic: scheduling postoperative visits outside of the global period
Replies: 4
Views: 4688

Re: scheduling postoperative visits outside of the global pe

Hi everyone; I wanted to come back and share what I have learned about this particular scenario.... First off, it is industry standard to see patients approximately four to six weeks after tube placement, and not within the ten day global that is attached to the CPT code. This is industry wide, and ...
by maryanne
Thu Apr 23, 2015 12:02 pm
Forum: Medical Auditing Forum
Topic: scheduling postoperative visits outside of the global period
Replies: 4
Views: 4688

Re: scheduling postoperative visits outside of the global pe

Thank you very much for your reply. We are actually in the process of gathering information regarding the standard of care, so it was nice to hear an affirmation!
by maryanne
Tue Apr 21, 2015 1:26 pm
Forum: Medical Auditing Forum
Topic: scheduling postoperative visits outside of the global period
Replies: 4
Views: 4688

Re: scheduling postoperative visits outside of the global pe

I was able to find a Medicare guideline that states..... Nonparticipating physicians who furnish less than the full global package, but who bill for the entire global surgery, may be guilty of violating their charge limits. In addition, physicians who engage in such practices may be guilty of fraud....
by maryanne
Mon Apr 20, 2015 6:49 pm
Forum: Medical Auditing Forum
Topic: scheduling postoperative visits outside of the global period
Replies: 4
Views: 4688

scheduling postoperative visits outside of the global period

Hello everyone, I have an interesting situation, and was hoping that someone could direct me to some Medicare guidelines about this scenario..... I have a clinic who performs tympanostomy / tube placements, which have a ten day global. This clinic ROUTINELY schedules the first postoperative visit we...
by maryanne
Mon Apr 13, 2015 1:03 pm
Forum: Weekly Tip Comments & Discussions
Topic: Weekly tip 69210 - instrumentation
Replies: 2
Views: 2436

Re: Weekly tip 69210 - instrumentation

I may be really off base here, but I do not believe that they would have to document the use of the otoscope. To me, it would be like saying that the provider had to document that they listened to the heart with a stethoscope. I think that it would be a given that they used a stethoscope, or an otos...
by maryanne
Tue Apr 07, 2015 3:48 pm
Forum: Weekly Tip Comments & Discussions
Topic: ICD-10 Challenge - Laceration
Replies: 1
Views: 2051

ICD-10 Challenge - Laceration

Okay, I'll take a STAB at this coding challenge (Ha, ha, ha) :D Scenario: Laceration of the left index finger with a knife while preparing meat at the restaurant of employment. Assuming this is the initial encounter: ICD 9: 883.0 Open wound, finger, without mention of complication E920.3 Accidents c...
by maryanne
Mon Mar 30, 2015 12:28 pm
Forum: Weekly Tip Comments & Discussions
Topic: ICD-10 Challenge
Replies: 2
Views: 2390

Re: ICD-10 Challenge

Hi there, There is really not enough documentation and I would query the provider, however, given the information that is provided: 1) H90.12 is for conductive hearing loss of the left ear. We don't know that the hearing loss is conductive, or sensorineural, or mixed, nor do we know which ear - righ...