Billing & Coding

The Diagnostic and Statistical Manual for Mental Disorders (DSM) is the standard classification of mental disorders used by mental health professionals in the United States. It is generally accepted as the authoritative guide for the diagnosis of mental disorders. This FAQ article was created to address some commonly asked questions about DSM coding and clear up some common misconceptions.
 

Read entire article on InstaCode Institute   https://instacode.com/DSM-FAQ

Modifiers are used to help describe the encounter, and used to further explain the procedure to the payer. Modifiers will be used if the procedure does not fit or clearly explain the entire encounter.  

There are two types of modifiers:

  • Informational modifiers that do not impact reimbursement
  • Pricing or Payment modifiers that always impact reimbursement

Claims processing requires the pricing modifier in the first position to be processed correctly.

The diabetes mellitus codes are combination codes that include the type of diabetes mellitus, the body system affected, and the complications affecting that body system.

When documenting diabetes, include the following:

  1. Type e.g. Type 1 or Type 2 disease, drug or chemical induced, due to underlying condition,     gestational

  2. Complications What (if any) other body systems are affected by the diabetes condition? e.g. Foot ulcer related to diabetes mellitus

  3. Treatment Is the patient on insulin?

Are you getting ready to take the AAPC ICD-10-CM Proficiency Exam? Maybe you're a medical coder that wants to be prepared for the future in your field and know everything you need to know about ICD-10?  This is Alicia Scott, CPC, CPC-I, Educational Director with CCO, and we have a fantastic ICD-10-CM Proficiency Exam Training course that will do just that for you. It's called our ICD-10 Blitz.

Who Needs the ICD-10-CM Training Blitz?

Certified Medical Coders

One of the significant coding changes with ICD-10-CM was including laterality within the code itself. This concept should help reduce billing errors and claim denials. Interestingly, CMS issued a statement regarding the reporting of laterality in their provider newsletter (emphasis added).

Reporting Laterality Still Requires Modifiers

One of the significant coding changes with ICD-10-CM was including laterality within the code itself. This concept should help reduce billing errors and claim denials. Interestingly, CMS issued a statement regarding the reporting of laterality in their provider newsletter (emphasis added).

UHIN offers an ICD-10 Peer Support Group. 

Q. How do I report ICD-10 codes on claims when the dates of service span from prior to 10/1/2015 to on or after 10/1/2015?

A.  Many payers are requiring claims with dates of service that span the October 1, 2015 implementation date to be split so that the services prior to 10/1/2015 are billed separately and utilize ICD-9 codes; services on and after 10/1/2015 are billed separately and utilize ICD-10 codes.

Check specific payer guidelines for processing claims for services that span the 10/1/2015 ICD-10 transition date.

Medicare has updated their provider educational tools for the Initial Preventive Physical Examination (IPPE) and the Annual Wellness Visit (AWV). These tools were designed to help providers gain a greater understanding of these services. Learn what the required elements for these services as well as important coverage and coding information.

CLICK HERE to download "The ABCs of the Initial preventive Physical Examination (IPPE)" booklet.

What To Do When Your Claim Is Lost

What to Do When Your Claim Is Lost

by Tom Necela, DC, CPC, CPMA
January 2010

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