Search found 42 matches

by JJones
Sun Aug 27, 2017 1:19 pm
Forum: Medical Auditing Forum
Topic: New or Established PROBLEM w/no tx after 2 years
Replies: 1
Views: 609

New or Established PROBLEM w/no tx after 2 years

Hello! We have a patient that saw our provider 2 years previously needing a referral for a stomach issue. He went to the referred provider and found that he had to have a series of blood tests that his insurance would not pay for, so he did not pursue any more treatment until now, 2 years later. He ...
by JJones
Wed Aug 16, 2017 6:28 pm
Forum: Medical Auditing Forum
Topic: Clarification - New or Est Problem to provider?
Replies: 1
Views: 688

Clarification - New or Est Problem to provider?

Hello! One of our coders has come across an interesting scenario today, and we are not sure how to proceed to bill correctly. A patient came to one of our Family med providers in February of 2015. He knew he has a dx of hepatitis C, and was looking for a referral to a gastroenterologist, which our p...
by JJones
Tue Aug 08, 2017 6:29 pm
Forum: Medical Auditing Forum
Topic: Correct coding of Smoking - "Use" vs. "Dependence"
Replies: 1
Views: 618

Correct coding of Smoking - "Use" vs. "Dependence"

Hello! We are very interested in knowing the correct coding for these statements: 1. "Current every day smoker, .25 packs a day, cigarettes, times 10 years". This example was taken from the medical record history that was noted as reviewed by the provider. Is it acceptable to use information strictl...
by JJones
Wed Aug 02, 2017 3:22 pm
Forum: Medical Auditing Forum
Topic: CRC Credential
Replies: 1
Views: 648

CRC Credential

Hello! Are there any NAMAS members that have this credential and are currently using it? I would be very interested in talking with you if so.

Thank you,

JJones
by JJones
Tue Jun 27, 2017 4:12 pm
Forum: Medical Auditing Forum
Topic: HCC Auditing/Coding
Replies: 1
Views: 578

HCC Auditing/Coding

Hello! The group I work with is moving to HCC coding and auditing. We are going into this pretty blind, and I am hoping to connect with someone who does HCC auditing and also provider education. Any guidance would be appreciated! I am also looking for an audit tool specifically for HCC coding. I kno...
by JJones
Sun May 21, 2017 1:19 pm
Forum: Medical Auditing Forum
Topic: 99024 vs. problem visit
Replies: 2
Views: 1112

99024 vs. problem visit

Could someone please give advice on the following note? The scenario is that this note and charge was selected for a Provider's recent review. The coder and myself agreed originally that this should be billed as a 99024. The provider has rebutted saying that "I indicated in my note that the care I w...
by JJones
Thu Mar 09, 2017 7:37 am
Forum: Medical Auditing Forum
Topic: "Note must Stand Alone"
Replies: 1
Views: 913

"Note must Stand Alone"

Hello! We are trying to locate the exact place where the phrase "all notes must stand alone" comes from. Is it a CMS directive? We have been unable to find anything while searching their website. Thank you in advance for any guidance and/or direction you can give.
by JJones
Mon Mar 06, 2017 7:43 pm
Forum: Medical Compliance Forum
Topic: "Notes must stand alone"
Replies: 2
Views: 2460

"Notes must stand alone"

Hello! We are trying to locate where the phrase "all notes must stand alone". We see this statement often, but are unclear as to where it comes from. Is it a CMS directive? We have been unable to find anything while searching their website. Thank you in advance for any guidance and/or direction you ...
by JJones
Tue Feb 28, 2017 11:50 am
Forum: Medical Auditing Forum
Topic: Diagnosis Coding for Inpatient Postpartum care patients
Replies: 1
Views: 806

Diagnosis Coding for Inpatient Postpartum care patients

Hello! We have recently received results of an outside audit of our OBGYN coders and they are asking that I submit the scenario in question to this forum for guidance. The Coders are using Z39.0 as primary dx for the subsequent inpatient hospitalization visits following the delivery (along with any ...
by JJones
Mon Jan 16, 2017 1:23 pm
Forum: Medical Auditing Forum
Topic: Lab Results as diagnosis
Replies: 1
Views: 953

Lab Results as diagnosis

Hello! Is there anything written to show if it is acceptable to use a lab result that comes in after the patients visit (examples: strep results, biopsy results) in place of a symptom dx? Scenario would be for charges that have not been submitted on the DOS the patient was seen. Several of us were t...