Upcoding HCCs–Diabetes

Upcoding HCCs–Diabetes

What is an HCC? An HCC is a Hierarchical Condition Category which is used to calculate risk scores that may predict the future cost of healthcare for enrollees. HCCs were implemented by the Centers for Medicare and Medicaid (CMS) and have been adopted by Medicare...
Scaling and Planing Concerns

Scaling and Planing Concerns

What is Scaling and Planing? Scaling is the process of removing plaque and tarter from below the gumline. Planing (Root Planing or Curettage) is when the patient’s tooth root is smoothed out which helps the gums to reattach to the tooth. [1] Patients exhibiting...
Oh, Oh….Ozempic

Oh, Oh….Ozempic

Ever have a commercial jingle stuck in your ahead? If you haven’t heard the Ozempic jingle feel free to listen here. Manufactured by Novo Nordisk, Ozempic is prescribed to patients to treat Type 2 diabetes and to reduce the risk of adverse cardiovascular events. Novo...
Coding Crisis Psychotherapy

Coding Crisis Psychotherapy

What is Crisis Psychotherapy? Crisis Psychotherapy is a session that occurs between the provider and the patient due to a life-threatening or highly complex issue that requires immediate attention.[1] According to the coding guidelines, “Psychotherapy for crisis is an...
Small Patients, Big Challenges: Using Modifier 63

Small Patients, Big Challenges: Using Modifier 63

This article delves into modifier 63, a key piece for dealing with the smallest patients, infants weighing less than 4 kg.  Modifier 63 addresses the additional time, complexities, and challenges of treating infants under 4kg or about 8.8 pounds.  To put this in...
2023 Hernia Repair Code Changes

2023 Hernia Repair Code Changes

What is Hernia? Hernia is when an organ or fatty tissue squeezes through a weak spot in a surrounding muscle or connective tissue called fascia. There are several types of hernia including inguinal (inner groin), incisional (resulting from an incision), femoral (outer...