The Field Guide to Physician Coding, 4th Edition

Betsy Nicoletti

• Publisher: American Association for Physician Leadership
• Year: 2018
• ISBN:
  9780999355374
• Topic: Medicine
• Subtopic: Public Health, Administration & Care

"All Physicians can increase their revenue and improve their compensation through accurate coding. This book tells you how."

The Field Guide to Physician Coding, 4 th Edition delivers a payload of precise information on coding rules and relevant billing guidelines. Betsy Nicoletti selects topics that answer the questions she is asked most frequently in her speaking and consulting work.Her explanations are clear and detailed and tell the practice what it needs to know to code for services. Nicoletti also steers you to critical source documents for today's coding rules so you don't have to spend hours hunting for key facts in long official documents.

This book is organized, in a way that makes looking up topics easy. The book simplifies complex coding rules and provides source citations for the reader.

NEW AND UPDATED FOR THIS EDITION!

• Anticoagulation management coding
• Care management for behavioral conditions
• Non-face-to-face prolonged services CPT codes
• Prolonged services for wellness visits, new HCPCS codes
• Psychiatric collaborative care coding
• Cognitive assessment and care plan services
• Chronic care management
• Critical care
• Global surgical package

Coding drives revenue in medical practices and physician compensation, and as you know, coding is also a risky endeavor because of the necessity to do it right.

There is Complexity: coding is complex, and practices find it hard to be certain if they are doing it correctly.There is Change: the codes and rules change every year and a practice needs to stay up to date. And there is Concept: this is a book that explains the concepts that drive coding.

Designed with the most common coding issues that plague medical practices in mind, Betsy Nicoletti's "No-nonsense" advice supported by weblinks that answers the most pressing questions from physicians, practice managers, billers and coders.

• The "rules" that help doctors get paid, not just the codes
• Organized alphabetically, by topic, for ease of use
• Relevant to all specialties
• Detailed explanations

Each entry includes:

• The definition of the service
• Explanation of billing rules
• Key points
• Clinical examples, when relevant
• CPT or CMS references

With The Field Guide to Physician Coding, 4 th Edition, there is a confidence that the claims sent to the insurance company are accurate and compliant.Sleep well knowing that your practice is compliant with government rules and you're collecting all the money you are entitled to collect!

Table of contents

• Dedication
• About the Author
• Introduction
• Advance Beneficiary Notice (ABN)
• Advance Care Planning
• Anticoagulation Management
• Assistant at Surgery Services
• Care Management for Behavioral Health Conditions
• Care Plan Oversight (CPO) – CPT® Codes (Non-Medicare)
• Care Plan Oversight for Medicare Patients
• Category of Code Charts
• Certification of Home Health Services
• Cerumen Removal
• Chronic Care Management (CCM)
• CLIA Waived Tests
• Cloning Notes in an Electronic Health Record
• Cognitive Assessment and Care Plan Services
• Comprehensive Error Rate Testing (CERT)
• Consolidated Nursing Home Billing
• Consultations
• Critical Care Services
• Diagnosis Coding
• Documentation Guidelines
• Emergency Department Visits
• Evaluation and Management Services and Profiles
• Foot Care: Routine
• General Principles of Medical Record Documentation
• Global Surgical Package
• Healthcare Common Procedure Coding System (HCPCS)
• Hierarchical Condition Categories (HCCs)
• Hospital Discharge Services
• Hospital Initial Services, Inpatient
• Hospital Observation Services
• Hospital Subsequent Services
• ICD-10-CM
• Immunization Administration for Vaccinations
• Incident to Services (Medicare)
• Local Coverage Determinations (LCDs)
• Locum Tenens Billing
• Medical Necessity
• Medicare Physician Fee Schedule Database (MPFSDB)
• Mini Mental Status Exam
• Modifier 22—Increased Procedural Service
• Modifier 24—Unrelated E/M Service During a Postoperative Period
• Modifier 25—Significant, Separately Identifiable E/M Service on the Same Day of the Procedure or Other Service
• Modifier 26—Professional Component
• Modifier 33—Preventive Service
• Modifier 50—Bilateral Procedure
• Modifier 51—Multiple Procedures
• Modifier 52—Reduced Services
• Modifier 53—Discontinued Procedure
• Modifier 58—Staged or Related Procedure
• Modifier 59—Distinct Procedural Service
• Modifier 78—Unplanned Return to the Operating Room
• Modifier PT—A Colorectal Cancer Screening Test Which Led to a Diagnostic Procedure
• Multiple Endoscopic Procedures
• Multiple Surgical Procedures
• National Correct Coding Initiative (NCCI)
• National Coverage Determinations (NCDs)
• New Patient
• Nurse Visit
• Nursing Facility Visits
• Osteopathic Manipulative Treatment
• Pelvic and Breast Clinical Exam
• Preoperative Exams
• Preventive Medicine Services
• Preventive Medicine Services (Medicare)
• Prolonged Services—Face-to-Face
• Prolonged Services—Non-Face-to-Face Codes: 99358 and 99359
• Prolonged Services: Healthcare Common Procedural Coding System (HCPCS) Codes for Preventive Care
• Psychiatric Collaborative Care Management Services 99492, 99493, 99494
• Reviewing Medical Records
• Shared Visits (Medicare)
• Smoking Cessation Counseling
• Teaching Physician Rules Based on Time
• Teaching Physician Rules for Critical Care Services
• Teaching Physician Rules for Evaluation and Management Codes
• Teaching Physician Rules for Medical Students
• Teaching Physician Rules for Primary Care Exception
• Teaching Physician Rules for Surgical Procedures
• Telephone Calls
• Time-based Codes
• Transitional Care Management (TCM) Services
• Welcome to Medicare
• Wellness Visits: Initial and Subsequent