Back to Basics — Documentation 101 and Self-Auditing
Blue Cross Targeting Modifier 50 Misuse
CMS Eliminates Consultation Payments
Correct Code for Billing a Routine Venipuncture
E&M Coding Advice
Emergency Diagnosis Codes Related to Pregnancy
Eye E&M Codes Subject to New Medicare Coding Edit
“Incident to” and the Initial Medicare Visit
Modifiers 22, 52, and 53 for Medicare Claims
Unraveling Modifier 25
Why Was the Code I Submitted Returned as Truncated?
Coding and Documentation Review: A comprehensive analysis of a physician’s coding and documentation techniques presented in a written report with specific findings and opportunities for improvement. Audits are performed by a TMA Practice Management Consultant who is certified as a professional coder and a professional medical auditor. Audits are a review of claims, coding, and medical record documentation to determine whether the practice is following the coding guidelines for appropriate billing. Audits may be performed on annual or quarterly basis. (Approved for 20 AMA PRA Category 1 Credits™)
Coding and Documentation Check-ups: An abbreviated review of claims coding and medical record documentation performed by a professional coder and auditor to provide a glimpse into a physician’s coding techniques. Simplified reporting of the check-up findings allow physicians to step-back from the details and realize the underlying trends that directly affect practice revenue through visual illustration.
Coding and Documentation Training: On-site training for physicians and staff on the coding and documentation guidelines, customized to the practice’s specialty. Training also includes education on how to identify inappropriate coding practices and weaknesses in the medical record that may expose the practice to problems with payers or third-party audits. (Approved for up to 2 AMA PRA Category 1 Credits™)
TMA Mini-Consultation Program: Having problems with coding, billing, reimbursement, denial of services, or filing of claims? TMA staff travel to county medical societies across the state and conduct free 30-minute sessions with individual practices on these topics. Each physician or office staff member who attends receives a free handbook full of helpful articles and reference materials, and a packet of TMA resources on managed care, practice management, and more. Contact your county medical society to schedule a mini-consultation. Free to TMA members.
TMA Endorsed ServicesAvailable only to TMA members, endorsed vendor programs are an excellent value that can help you succeed in the ever changing medical practice environment.
InGauge Healthcare SolutionsAs a member of Texas Medical Association, you receive a group purchasing discount on Medical Coding & Billing products through an arrangement with InGauge Healthcare Solutions, Inc. If you need medical billing and coding books for CPT®, ICD-9, HCPCS, physician’s fee guides, coding guides, look no further than www.CodersCentral.com.
Evaluation and Management (E/M) Services: Overview Fact Sheet - CMS (PDF)
Medicare Fee Schedules
Sample Letter (SB 418): Appeal Letter for Services Incorrectly Denied
Sample Letter: Getting to Know a Carrier's Surgical Billing Principles
Pay Attention to ICD-10’s Seventh Character (E-Tips, June 23, 2015)
ICD-10 Redux. Will You Be Ready This Time? (E-Tips, Mar. 11, 2015)
Let the Prepping Begin for ICD-10 (Action, Mar. 2, 2015)
CMS Sets ICD-10 Testing Dates (Action, Sept. 15, 2014)
HHS Officially Sets ICD-10 Deadline for Oct. 1, 2015 (Action, Aug. 15, 2014)
ICD-10: Use Documentation, Not Mapping Tools
(E-Tips, Sept. 27, 2013)
Does Your Practice Have an ICD-10 Physician
Expert? (Action, Sept. 4, 2013)
ICD-10: What’s the Cost? (E-Tips, July 23, 2013)
A Local Solution for ICD-10 Training (Action, May 15, 2013)
ICD-10: What Should I Do Now? (Action, Jan. 15, 2013)
ICD-10 Prep May Take Longer Than You Think (Action, Jan. 4, 2013)
Change to HHS Proposes One-Year Delay of ICD-10 Compliance Date
CMS AAPC ICD-10 Code-a-thon - CMS and the American Academy of Professional Coders (AAPC) collaborated on an ICD-10 Code-a-thon on April 26, 2011. Coding experts from AAPC responded to nearly 250 questions from the more than 1,200 participants who joined online or by phone. These materials should be helpful in getting informed and learning about the transitions to Version 5010 and ICD-10.
Presentations from AAPC and CMS on ICD-10 and Version 5010
A transcript and audio of the presentations given during the webinar
ANSI 5010 and ICD-10 - The means by which Blue Cross and Blue Shield of Texas (BCBSTX) exchanges member data with providers will change dramatically over the next several years. The changes – upgrading ANSI 4010 to ANSI 5010 and ICD-9 to ICD-10 – are required by a new directive from the U.S. Department of Health and Human Services (HHS). That directive makes the same requirement of providers.
ANSI Version 5010/ICD-10 - 2011 Webinars
ICD-10 Basics for Medical Practices - CMS (PDF)
Talking to Your Vendors About ICD-10 and Version 5010: Tips for Medical Practices - CMS (PDF)
Talking to Your Customers About ICD-10 and Version 5010: Tips for Software Vendors - CMS (PDF)
AMA CPT®: Current Procedural Terminology
Centers for Medicaid & Medicare Services
TMA Knowledge Center
Trailblazer Health Enterprises provides services to Medicare beneficiaries and health care professional