Respiratory Question for the Week of August 2, 2021
MedLearn Publishing
August 1, 2021
Can we bill code 94799 for oxygen?
Can we bill code 94799 for oxygen?
How is the following scenario coded? A patient undergoes angioplasty and bare-metal stenting of a distal LC lesion through a vein graft followed by the placement of a separate drug-eluting stent in the proximal native vessel via a separate access.
Are codes for vascular access and injection of radiopharmaceutical separately reportable?
Regarding the Appropriate Use Criteria (AUC) program, CMS recently stated “Currently, the program is set to be fully implemented on January 1, 2022, which means AUC consultations with qualified CDSMs are required to occur along with reporting of consultation information on the furnishing professional and furnishing facility claim for the advanced diagnostic imaging service. Claims that fail to append this information will not be paid.” Our hospital images are read by an outsourced radiology group. Will the hospital still receive payment for the technical portion if AUC requirements are not met? Will the radiologist’s claim be completely denied?
In regards to nuclear medicine and radiopharmaceuticals, what codes were added to the Designated Health Service list?
Medicare payment policies and rates are set to be adjusted for the 2022 fiscal year as a result of the moves. The Centers for Medicare
The PFS proposal also includes a signature requirement. Last week, the Centers for Medicare & Medicaid Services (CMS) issued the proposed 2022 Physician Fee Schedule.
New CDC mask guidance, plus release of the CMS OPPS proposed rule highlight week in the nation’s capital. The Centers for Disease Control and Prevention
Alleged overpayment and audit findings in violation the Jimmo settlement. Today I will be writing about a settlement agreement between the Centers for Medicare &
Medicaid expansion advances in Missouri. Among news relating to the social determinants of health (SDoH) this week are the latest events associated with Medicaid expansion
EDITOR’S NOTE: Sharon Easterling, the newest member of the ICD10monitor editorial board, will be reporting on health equity while also sharing thoughts about her personal
Medical practices are leaving money on the table by under-coding. Are one or more of your physicians under-coding? Missing revenue? Or relying too much on
Federal auditors are intensifying their focus on inpatient psychiatric facilities, using advanced data analytics to spotlight outliers and pursue high‑dollar repayments. In this high‑impact webcast, Michael Calahan, PA, MBA, Compliance Officer and V.P., Hospital & Physician Compliance, breaks down what regulators are really targeting in IPF-PPS admissions, documentation, treatment and discharge planning. Attendees will learn practical steps to tighten processes, avoid common audit triggers and protect reimbursement and reduce the risk of multimillion-dollar repayment demands.
In this timely session, Stacey Shillito, CDIP, CPMA, CCS, CCS-P, CPEDC, COPC, breaks down the complexities of Medical Decision Making (MDM) documentation so providers can confidently capture the true complexity of their care. Attendees will learn practical, efficient strategies to ensure documentation aligns with current E/M guidelines, supports accurate coding, and reduces audit risk, all without adding to charting time.
Join Ronald Hirsch, MD, FACP, CHCQM for The PEPPER Returns – Risk and Opportunity at Your Fingertips, a practical webcast that demystifies the PEPPER and shows you how to turn complex claims data into actionable insights. Dr. Hirsch will explain how to interpret key measures, identify compliance risks, uncover missed revenue opportunities, and understand new updates in the PEPPER, all to help your organization stay ahead of audits and use this powerful data proactively.
Stay ahead of the 2026-2027 audit surge with “Top 10 Audit Targets for 2026-2027 for Hospitals & Physicians: Protect Your Revenue,” a high-impact webcast led by Michael Calahan, PA, MBA. This concise session gives hospitals and physicians clear insight into the most likely federal audit targets, such as E/M services, split/shared and critical care, observation and admissions, device credits, and Two-Midnight Rule changes, and shows how to tighten documentation, coding, and internal processes to reduce denials, recoupments, and penalties. Attendees walk away with practical best practices to protect revenue, strengthen compliance, and better prepare their teams for inevitable audits.
Gain clarity and confidence in OB‑GYN coding with this expert‑led webcast featuring Stacey Shillito, CDIP, CPMA, CCS, CCS‑P, CPEDC, COPC. You’ll learn how to apply global maternity package rules accurately, select the right CPT codes for procedures and visits, and identify documentation gaps that lead to denials. With practical guidance and real examples, this session helps you strengthen compliance, reduce audit risk, and ensure accurate reimbursement for women’s health services.
Uncover essential coding insights with nationally recognized coding authority Kay Piper, RHIA, CDIP, CCS. Through ICD10monitor’s interactive, on‑demand webcast series, Kay walks you through the AHA’s 2026 ICD‑10‑CM/PCS Quarterly Coding Clinics, translating each update into practical, easy‑to‑apply guidance designed to sharpen precision, ensure compliance, and strengthen day‑to‑day decision‑making. Available shortly after each official release.
Uncover critical guidance on the ICD-10-CM/PCS code updates. Kay Piper reviews and explains ICD-10-CM/PCS coding guidelines in the AHA’s fourth quarter 2026 ICD-10-CM/PCS Coding Clinic in an easy to access on-demand webcast.
Uncover critical guidance on the ICD-10-CM/PCS code updates. Kay Piper reviews and explains ICD-10-CM/PCS coding guidelines in the AHA’s third quarter 2026 ICD-10-CM/PCS Coding Clinic in an easy to access on-demand webcast.
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