Symposium on ICD-10 Conversion – February 2012
Tex Med. 2012;108(2):32-33.
By Crystal Conde
The Texas Medical Association can help your practice prepare to catch up to the rest of the world in using the International Statistical Classification of Diseases and Related Health Problems (ICD)-10 to capture health care information more efficiently. TMA Practice Consulting offers a variety of services to help ensure your reimbursement doesn't suffer during the transition. Don't delay in ICD-10 planning and implementation. The Centers for Medicare & Medicaid Services (CMS) has set a firm compliance date of Oct. 1, 2013.
To inquire about any of the following services, contact TMA Practice Consulting by telephone at (800) 523-8776 or by email. All services are available for a fee based on a practice's needs.
Coding and Documentation Customized Training
TMA Practice Consulting offers an on-site training program for practices that need help understanding documentation guidelines or identifying inappropriate or inaccurate coding and weaknesses in medical record documentation. The two-hour session, customized to the practice specialty, covers a review of 1995 and 1997 evaluation and management (E&M) documentation guidelines, time-based coding, modifiers, and audit triggers, among other topics. It is approved for up to 2 AMA PRA Category 1 Credits™.
Coding and Documentation Reviews
Get a glimpse into your coding techniques with E&M coding and documentation reviews from TMA Practice Consulting. The reviews include a claims coding and medical record documentation analysis of 10 records per physician. An abbreviated checkup and a comprehensive review are available. TMA Practice Consulting also can conduct a quarterly coding and documentation review to determine whether a medical practice is following payers' guidelines for appropriate billing year-round. Simplified reporting of the checkup findings allows physicians to step back from the details and realize the underlying trends that directly affect practice revenue through visual illustration.
Case Study: TMA Practice Consulting set up Texas Diabetes & Endocrinology in 2001 and performs coding and documentation training and reviews for the practice twice a year. Valerie Espinosa, MD, an Austin endocrinologist at the practice, credits the regular reviews and training sessions with giving her more confidence in her coding and documentation skills.
"All of our physicians have coding cards on their desks for reference to make sure they've fulfilled all requirements to justify a certain level of coding. I feel assured I'm doing things the right way. I'm no longer living in fear that I'll get audited," she said.
Comprehensive Chart Audits
Have your coding and documentation techniques thoroughly analyzed and the findings presented in a formal, written report that outlines opportunities for improvement. TMA Practice Consulting reviews a practice's documentation for accurate CPT coding; appropriate application of CPT coding guidelines; E&M coding guidelines; correct use of modifiers; encounter forms; claims; and corresponding explanations of benefits to ensure accurate billing and reimbursement levels. TMA Practice Consulting can perform audits on a monthly, annual, or quarterly basis. Audits are approved for 20 AMA PRA Category 1 Credits™.
Case Study: Stephen Raley, MD, a family physician with Hillcrest Family Health Center in Waco, says an external coding audit is a "necessary expense" that gives a practice peace of mind.
"Since consulting with TMA, our group is better educated on the importance of proper documentation in a timely manner. We have implemented a chart completion policy, and we hope our coding accuracy has improved, resulting in increased revenue and improved compliance."
Meet Your TMA Certified Coders
- Heather Bettridge, CPC, CPMA, is a practice management consultant with more than 10 years of experience developing and refining private practices. She's certified as a professional coder and a professional medical auditor by the American Academy of Professional Coders.
- Erin Gregorcyk Smith, CPC, is a TMA staff reimbursement specialist in the Payment Advocacy Department. She educates physician practices on proper billing and coding techniques, as well as advocates on their behalf with insurance companies to resolve reimbursement hassles.
- Liz Jero, CPC, is a TMA staff reimbursement specialist in the Payment Advocacy Department. She's a member of the American Academy of Professional Coders and the Professional Association of Health Care Office Management.
Crystal Conde is associate editor of Texas Medicine.
February 2012 Texas Medicine Contents
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