Authored by MedLearn consultants known for their leadership in each specialty area, these invaluable guides reflect their real-world experiences and expertise.
In today’s audit environment, you cannot afford the risk of improper coding and billing. Wolters Kluwer is pleased to offer the well-known MedLearn Specialty Handbooks, now fully searchable within the Coding Suite and Compliance Suite.
Coding Essentials for Hospital Infusion Services
For many coders, “infusion” means “confusion” with coding hierarchies and the AMA’s “other highly complex” drug classification. Just one instance of miscoding could place your hospital at significant risk for lost revenue or overcharging. End the confusion and code with complete confidence using this eBook, which walks you through the practical application of AMA and CMS coding and documentation guidelines for hospital outpatient infusion services.
- Quickly find the information you need using the quick-reference format, divided by infusion service type.
- Easily reference CPT/HCPCS and revenue center codes, intended use explanation, billing tips, drugs examples, NCCI edits and case studies.
- Get step-by-step guidance through the assignment of primary and secondary codes, based on level of complexity.
- Focus on medical necessity and other potential areas under scrutiny by Recovery Audit Contractors (RACs).
Coding Essentials for Laboratories
This comprehensive eBook answers your laboratory and pathology coding, billing and compliance questions for hospital-based, physician office and independent laboratories using concise, straightforward language.
- Stay up to date with detailed descriptions of current year CPT/HCPCS coding additions, deletions and revisions for all laboratory and pathology services.
- Get step-by-step guidance for utilizing the entire 80XXX CPT code series clinical diagnostic laboratory tests, plus pathology, cytology, histology and blood products.
- Capture every appropriate reimbursement dollar while preventing errors that may be red flags for recovery auditors using the extensive coding and billing tips.
- Understand Correct Coding Initiative (CCI) information and how it applies to the billing code pairs and modifier use.
- Identify frequent errors by CPT code, via Comprehensive Error Rate Testing (CERT).
Coding Essentials for RT/Pulmonary Function
Know the answers to which respiratory services are billable and how to correctly code for pulmonary function testing, as well as many other questions in this highly audited area, with this clear and succinct eBook.
- Get step-by-step guidance through CPT/HCPCS code usage and format, modifiers and chargemaster review methods.
- Gain clarity into which services are and are not billable with an overview of Medicare medical necessity coverage policies and frequency limitations, local coverage determinations, including a listing of Medicare policies and links to FI/MAC LCD web sites, as well as billing rules for respiratory therapists vs. nursing personnel.
- Learn how to avoid common mistakes, such as the unbundling of codes for pulmonary function testing.
- Understand the CCI and CMS edit tables with detailed explanations.
- Learn how to correctly use the add-on codes.
CT and MR study technology has advanced tremendously, faster than coding and billing practices can keep pace. Trust our eBook o equip you to receive full appropriate reimbursement while avoiding compliance pitfalls by walking you through the complexities involved in coding these procedures.
- Find detailed billing guidance for all codes defining CT and MR procedures, by both hospitals and physicians.
- Gain a clear understanding of the rules and regulations involving CT, CTA, MRI, A and MRV.
- Learn to tackle common challenges, such as billing for MRA procedures and combination MRI procedures, reconstruction charges and coronary/cardiac CT/CTA studies.
- Learn coding and charging for infusions and injections as well as how to utilize infusion therapy codes in conjunction with CT/MR services.
- Maintain accurate billing with updated APC and RVU payment info, including comprehensive RVU tables for physician work, facility, non-facility and total.
- Find guidance on medically unlikely edits (MUEs) and Correct Coding Initiative (CCI) policy.
Emergency Department Charging and Coding Handbook
While more hospitals are consolidating their ED coding and charging functions under the HIM department, coders often struggle in this role, especially when faced with unclear or missing documentation. This unique how to eBook will equip you to efficiently handle ED-related responsibilities.
- Quickly find procedural coding guidelines for ED services and drug administration, grouped by body system for fast lookup.
- Learn by doing with coding exercises for some of the most common procedures, using documentation extracted from actual cases.
- Get special help with correctly applying complex coding hierarchies and modifiers for hydration, injections and infusion services.
- Utilize the included documentation required of ED nurses to support code selection.
- Easily reference charging guidelines for critical care, infusion services and injections as well as a complete list of chargeable items for facility-level payment of evaluation and management (E&M) services.
- Stay up-to-date with updated Medicare payment information for ED services as well as fully updated current CPT codes and modifiers.
- Gain clarity into the infusion coding rule.
Interventional Radiology Coder
Designed to speed you to the right CPT code for over 400-plus procedures, this top-selling eBook contains easy-to-follow menus of correct code assignments.
- Gain complete understanding of critical issues, such as angiographic and interventional procedures by body system, as well as the completely revised codes for diagnostic cardiac catheterization.
- Stay up-to-date with the current code additions and revisions for all interventional radiology procedures.
- Maintain accurate billing with the most current payment rates for hospitals (APCs) and physician practices (RVUs).
- Find guidance on medically unlikely edits (MUEs) and Correct Coding Initiative (CCI) policy.
Interventional Radiology Color Coded Charts
A perfect complement to the Interventional Radiology Coder, these high-resolution color-coded charts will quickly guide you to the right codes and charges the first time and every time.
- Stay current with up-to-date codes for surgical catheter replacement.
- Gain clear understanding of the rules governing selective coding with this visual interpretation.
- Gain efficiency with some of the most common procedures with at-a-glance coding combinations.
Peripheral & Cardiology Coder
Dozens of codes for diagnostic cardiac cath and interventions of the lower extremities have been replaced by “combination” codes. Count on this unique resource to walk you through these sweeping changes, showing how to code it right the first time.
- Learn coding for non-invasive and invasive diagnostic cardiac services, electrophysiology and cardiac rhythm management.
- Get billing guidance for cardiac catheterization, with and without imaging supervision, interpretation and report.
- Understand coding strategies for conscious sedation, along with time-based calculations.
- Gain clarity into coding and charging for the various types of contrast used during diagnostic cardiology and/or interventional radiology procedures.
- Reinforce and accelerate learning with coded case studies and high-quality coding diagrams showing anatomy.
- Quickly reference the Medicare physician fee schedule, hospital OPPS, CPT codes and modifiers (Levels I and II) using the included appendices.
Nuclear Medicine & PET Coder
Under-reporting units for radio pharmaceuticals, missing codes for common procedures, and unbundled billing: mistakes like these occur all too often in settings where nuclear medicine procedures are performed. Count on this eBook to help you navigate this very complex area of medicine with confidence.
- Stay up-to-date with the current final Medicare payment policy for nuclear medicine and PET procedures, new and revised HCPCS codes and modifiers, current Medicare rates for hospitals, including APC categories and national HOPPS payment rates, and current RVUs for physicians, including the applicable professional, technical and global components of each code.
- Gain efficiency using the extensive coding and billing tips, grouped by body section.
- Hone in on PET with a dedicated section including an at-a-glance coverage table.
- Easily reference codes for lung scans, hepatobiliary scans (with and without intervention) and DaTscan.
- Overcome some of the most common areas of confusion, such as coding for parathyroid planar and/or SPECT imaging, with guidance from recent SNM consensus opinions.
Revenue Capture Guide for the Pharmacy
Submitting clean claims for hospital pharmacy services and supplies is challenging, but this eBook delivers the accurate answers you need to achieve both full appropriate reimbursement and consistent compliance with Medicare payment policies.
- Gain a comprehensive understanding of Medicare reimbursement rules for the hospital pharmacy department.
- Stay up-to-date with current payment information for the full range of pharmaceuticals, including drugs, biologicals and radio pharmaceuticals as well as updated HCPCS tables with current payment rate and billing units.
- Get clarity into coding and billing rules for dispensing pharmaceuticals in outpatient and inpatient settings.
- Find complete information in the chapter devoted to drug data, including two extensive tables with billable units of measure defined, one sorted by current ear codes and one by drug names.
- Easily reference detailed information on he expanded 340B Drug Pricing Program.