2022 Gastroenterology Reimbursement and Coding Update: Concrete Solutions to Strengthen Your Foundation in GI Coding and Billing (On-Demand) | November 2021-Summary of Top Coding and Reimbursement Issues Impacting Physicians and Facilities

Summary of Top Coding and Reimbursement Issues Impacting Physicians and Facilities

Video Transcription

Video Summary

In this video, the speaker summarizes the top coding and reimbursement issues discussed during the session. They touch on various issues including OIG and RAC audits, medical record signature requirements, ICD-10 specificity, substantiation of medical necessity, multiple endoscopy billing, hemorrhoid banding inconsistencies, and understanding modifier 25. The speaker then goes on to discuss specific issues related to OIG and RAC audits, such as billing for services not rendered or provided, improperly using provider identification numbers, unbundling services, failure to use coding modifiers properly, and clustering. They also discuss the importance of proper documentation, authentication of medical records, the need for ICD-10 specificity and medical necessity, and specific issues related to multiple endoscopy billing, hemorrhoid banding, and understanding modifier 25. The speaker emphasizes the importance of clear documentation, staying updated on payer policies, and maintaining open communication between staff and providers to ensure compliance with coding and reimbursement guidelines.

Asset Subtitle

Kathleen A. Mueller, RN, CPC, CGCS, CCS-P, CMSCS, PCS, CCC

Keywords

coding and reimbursement issues

OIG and RAC audits

medical record signature requirements

ICD-10 specificity

substantiation of medical necessity