<p>Written by nationally-renowned physician coding expert Betsy Nicoletti, The Field Guide to Physician Coding Second Edition delivers a payload of precise information on coding rules and relevant billing guidelines. Her explanations shed light on why the rules were created and how certain topics are linked to other information about which you must be aware. 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. Sleep well knowing that your practice is compliant with government rules and you're collecting all of the money you are entitled to collect! New for this Edition! Consults Wellness visits Changing Medicare Regulations Transition to ICD-10 E-prescribing Modifiers 53, 58 PPACA/Health Reform Act This book should be on the desk of every clinician, biller and coder in the country! No-nonsense advice supported by weblinks and a CD that answers the most pressing questions from physicians, practice mangers, bilkers and coders. The "Rules" that help doctors get paid, not just the codes Organized alphabetically, by topic, for ease of use Relevance to all specialties Rules explained in plain, easy-to-understand prose Each entry includes: The definition of the service --Reimbursement rules related to the service 2006 RVUs Clinical examples, when relevant Medical references, CPT rule references The Field Guide to Physician Coding Table of Contents Accounts Receivable Benchmark Data Adjusted Collection Ratio Advance Beneficiary Notice Aging Report Allergen Immunotherapy Assistant at Surgery Services Care Plan Oversight CPT Codes (Non-Medicare) Care Plan Oversight for Medicare Patients Certification of Home Health Services Cerumen Removal CLIA Waived Tests Comprehensive Error Rate Testing (CERT) Consolidated Nursing Home Billing Consultations Critical Care Services Days in Accounts Receivable Diagnosis Coding Documentation Guidelines Emergency Department Visits E-Prescribing Evaluation and Management Services and Profiles General Principles of Medical Record Documentation Global Surgical Package Gross Collection Ratio Healthcare Common Procedure Coding System (HCPCS) Hospital Discharge Services Hospital Initial Services, Inpatient Hospital Observation Services Hospital Subsequent Services Immunization Administration for Vaccinations Incident to Services (Medicare) Legibility Local Coverage Determinations (LCDs) Locum Tenens Billing Medical Necessity Medicare Physician Fee Schedule Data Base (MPFSDB) Mini Mental Status Exam Modifier 22 Modifier 24 Modifier 25 Modifier 26 Modifier 50 Modifier 51 Modifier 52 Modifier 53 Modifier 58 Modifier 59 Modifier 78 and Modifier 79 Multiple Endoscopy Procedures Multiple Surgical Procedures National Correct Coding Initiative (NCCI) National Coverage Determinations (NCDs) New Patient Nurse Visit Nursing Facility Visits OIG Work Plan Patient Protection and Affordable Care Act (PPACA) aka Health Care Reform Act of 2010 Pelvic and Breast Clinical Exam Physicians Quality Reporting Initiative (PQRI) Pre-operative Exams Preventive Medicine Services Preventive Medicine Services (Medicare) Prolonged Services Recovery Audit Contractor Initiative Reciprocal Billing Arrangements 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 Welcome to Medicare Wellness Visits (Personal Prevention Plan Services Guide to Acronyms Index</p>

The Field Guide to Physician Coding, Second Edition

Medical Books

Betsy Nicoletti

Allied Health Professions

Greenbranch Publishing

Protect your practice from governmental and third-party payer audits! This book explains complex reimbursement and coding rules and provides audit sheets for key, high-risk areas including E/M services. Today, medical practices face major risks if they don t code physician services accurately. Practices that violate the complex government regulations governing coding may face audits by the Office of the Inspector General for HHS, Recovery Audit Contractors and Medicare Administrative Contractors, and the consequences of such audits can be severe. Physicians and their staff now have a comprehensive guide available which helps practices audit high-risk areas themselves, before payers get involved.Auditing Physician Services: Verifying Accuracy in Physicians Services and E/M Coding To Protect Medical Practices, written by nationally-renowned coding and auditing expert Betsy Nicoletti, MS, CPC, offers critical information, support and plain-English explanations of how to avoid high-risk coding behavior. Auditing Physician Services, provides clear, practical, concrete explanations of complicated coding issues and E/M guidelines, advice on auditing EMR notes, and a range of worksheets allowing physicians to conduct valid, defensible audits. The book also includes an of the 2013 OIG Work Plan which offers insight into how the agency selects physician practices for further review. Contents Medical Practice Compliance and the 2013 OIG Work Plan General Principles of Medical Documentation Aberrant Evaluation and Management Coding Patterns How to Audit Evaluation and Management Services New Patient Visits Consultations Critical Care Services Billing for 99211 Incident To Billing and Shared Visits Use of Modifier 25 Billing for E/M Services During the Global Period Initial Preventive Physical Examinations and Annual Wellness Visits Teaching Physician Rules Care Plan Oversight BONUS Auditing Worksheets as you Audit Your Practice. Worksheets are available for download at the Nicoletti book website in Word Format so you can fill in the blanks! SELECTED Worksheets Include the following: Chapter 1: General Principles of Medical Documentation Audit Sheets General Principles of Medical Documentation--Individual Encounters General Principles of Medial Documentation--Medical Record as a Whole Chapter 2: Aberrant E/M Coding Patterns Audit Sheet Aberrant Evaluation and Management Coding Patterns Chapter 3: How to Audit E/M Services Audit Sheet E/M Documentation Auditing Worksheet Chapter 4: New Patient Visits Audit Sheet New Patient Visit Chapter 5: Consultations Audit Sheet Consult Audit Sheet Chapter 6: Critical Care Services Audit Sheet Critical Care Services Chapter 7: Billing for 99211 Audit Sheet Billing for 99211 Chapter 8: Incident to and Shared Visits Audit Sheets Incident to Test (Quiz and Answer Sheet) Incident to Audit Sheet for Non-physician Practitioner Services --Established Patient Visits Audit Sheet for Non-physician Practitioner Services -- New Patients Incident to Audit Sheet for Nurse Visits Services Shared Visit Audit Sheet Chapter 9: Use of Modifier 25 Audit Sheet Use of Modifier 25 Chapter 10: Billing for E/M Services During the Global Period Audit Sheet Use of Modifier 57 Use of Modifier 24 Use of Modifiers 54 and 55 Chapter 11: Initial Preventive Physical Examination and Wellness Visits Audit Sheets Initial Preventive Physical Examination Annual Wellness Visit Chapter 12: Teaching Physician Rules Audit Sheets Teaching Physicians Time-Based Codes Audit Sheet Teaching Physicians Primary Care Exception Audit Sheet Teaching Physicians Surgical Services Audit Sheet Minor Procedures Teaching Physicians Endoscopy Audit Sheet Teaching Physicians Surgical Services Audit sheet

Auditing Physician Services: Verifying Accuracy in Physician Services and E/M Coding to Protect Medical Practices

Administration & Medicine Economics

Nail It!: Insider Secrets on How to Score a Perfect 10 on Your Next Interview

Business & Money

SPHR

Kathy Wojcik

Job Hunting & Careers

Bluheron Coaching & Consulting

Take the steps to audit your practice...before the Government or Third-Party Payer does! A line-by-line update to the book including these "New" Sections for the 2nd Edition: Transitional Care Management (TCM) Chronic Care Management (CCM) EHR Cloning and Copy-Paste Over-documentation The key topics covered include a welcome amount of in-depth coding information -- topics and activities that practices perform every week. Protect your practice from governmental and third-party payer audits! This book explains complex reimbursement and coding rules and provides audit sheets for key, high-risk areas including E/M services. Today, medical practices face major risks if they don t code physician services accurately. Practices that violate the complex government regulations governing coding may face audits by the Office of the Inspector General for HHS, Recovery Audit Contractors and Medicare Administrative Contractors, and the consequences of such audits can be severe. However, physicians and their staff now have a comprehensive guide available which helps practices audit high-risk areas themselves, before payers get involved. Auditing Physician Services: Verifying Accuracy in Physicians Services and E/M Coding To Protect Medical Practices, written by nationally-renowned coding and auditing expert Betsy Nicoletti, MS, CPC, offers critical information, support and plain-English explanations of how to avoid high-risk coding behavior. Auditing Physician Services, provides clear, practical, concrete explanations of complicated coding issues and E/M guidelines, advice on auditing EMR notes, and a range of worksheets allowing physicians to conduct valid, defensible audits. The book also includes a detailed analysis of the 2015 OIG Work Plan which offers insight into how the agency selects physician practices for further review. TABLE OF CONTENTS Medical Practice Compliance and the 2015 OIG Work Plan Chapter 1: General Principles of Medical Documentation Chapter 2: Aberrant Evaluation and Management Coding Patterns Chapter 3: How to Audit Evaluation and Management Services Chapter 4: New Patient Visits Chapter 5: Consultations Chapter 6: Critical Care Services Chapter 7: Billing for 99211 Chapter 8: Incident To Billing and Shared Visits Chapter9: Use of Modifier25 Chapter 10: Billing for E/M Services During the Global Period Chapter 11: Initial Preventive Physical Examinations and Annual Wellness Visits Chapter 12: Teaching Physician Rules Chapter 13: Care Plan Oversight Chapter 14: Transitional Care Management (TCM) and Chronic Care Management (CCM) Final Thoughts Appendix 1: E/M Documentation Auditing Worksheet Index

Auditing Physician Services: Verifying Accuracy in Physician Services and E/M Coding to Protect Medical Practices, 2nd Edition

The goal of the medical home is simple: to obtain the best possible outcomes for patients by coordinating the medical team s care with available community resources. This care delivery concept is called a patient centered medical home or PCMH. Whether your organization has refined its patient throughput, education, and related processes into a highly functional model or is just beginning the journey to become a medical home, the progression to PCMH recognition means accepting the imperative to be the most effective coordinator of patient care across all care settings, which may include primary, specialty, ancillary, inpatient, and community-based services. The PCMH circle of care also includes the patient s family, caregivers, and the broader community. This book can help your organization in applying for and obtaining recognition as a medical home through the National Committee for Quality Assurance (NCQA) Patient-Centered Medical Home program. A step-by-step guide, it assists your coordination of that journey by providing practical infrastructure in the form of concrete policies and procedures aligned with the NCQA s PCMH standards. The PCMH Guidebook Offers sample policies and procedures for you to reference as you complete the NCQA process Helps the developers of the organization s policies and procedures to best organize their written documentation at any step in the creation or revision process of a policy and procedure Contains samples of policies and procedures you can easily customize, reproduce, and implement for your organization Features a job description for a patient centered medical home health coach and protocols for holding team huddles Includes a customizable CD that allows you to align the content with your organization!

PCMH Policies and Procedures Guidebook

Elizabeth W. Woodcock

FACMPE

MGMA

<p>If your practice is like so many others, the telephones ring constantly. Because the telephone requires synchronous communication the practice and the patient must be on the line at the same time it is inherently inefficient and has long been a source of frustration for practices and patients alike. Yet the telephone is the most frequently used means of communication for patients to access your medical practice. With high volume and high expectations the telephone is an area ripe for opportunity. This book gives you the tools you need to take charge of your telephones so you can: Optimize patient access Measure your telephones to understand their current performance Improve the management of each type of call you receive in your practice Staff your telephones to ensure that you have the right number and skill mix of staff Use telephone scripts and tools for message-taking and callbacks to optimize customer service Select a telephone system and its related components to fully leverage technology Prepare for mixed-channel communication with patients, such as texting, e-mail, and Web portal Assess whether you need a consolidated call center, and if so, design and implement one that is right for your practice The telephone is a critical access point that requires appropriate staffing and management to provide value high quality at low cost. Indeed, in some medical practices, more care is provided and/or coordinated via the telephone than ever before. Nurse triage and advice, case management, health coaching, patient navigation, and telehealth are expanding to provide patients with new access channels for care. In addition, patient expectations regarding service and turnaround times associated with the telephones are heightened, with patients requesting answers to their questions now. Gone are the days of patients telephoning the practice and being transferred directly to voicemail, which is checked only a few times during the day. Your patients expect timely and informed responses each and every time they call your practice. This book is organized to make it easy for you to access the key tools you need to improve patient communication and access to your practice. Authors Elizabeth Woodcock, MBA, FACMPE, CPC, and Deborah Walker Keegan, PhD, FACMPE, have peppered the book with best practices highlighted to guide you in optimizing telephone performance. Use this book as a blueprint to measure, manage, and staff your telephones for optimal performance. Embrace the tools in this book to improve patient access by expanding to newer technologies, minimizing the need for patients to telephone your practice.</p>

It's Your Call: Mastering Telephones in Your Medical Practice

PHD.

Deborah Walker Keegan

As retirement plans continue to increase in variety and complexity, professionals need comprehensive yet clear coverage of the real-world issues that arise daily in connection with both qualified and nonqualified retirement plans.With more than 600 retirement plans questions asked and answered, 2016 Retirement Plans Facts provides proven and practical guidance in this changing arena. Coverage includes:- 401(k) Plans- Defined Benefit Plans- Defined Contribution Plans- Distribution Rules- Fiduciary Responsibilities- Mergers & Acquisitions- Nondiscrimination Testing- Plan-Owned Life Insurance- Plans for Nonprofits

2016 Health Savings Account Facts

J.D.

CPA/PFS

CLU®

ChFC®

Louis R. Richey

Stephen Abramson

Deborah Miner

John Phelan

Bruce A. Tannahill

National Underwriter Company

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