CPT coding is similar to ICD-9 and ICD-10 coding, except that it identifies the services rendered rather than the diagnosis on the claim. ICD code sets also contain procedure codes but these are only used in the inpatient setting.[5]CPT is currently identified by the Centers for Medicare and Medicaid Services (CMS)[6] as Level 1 of the Health Care Procedure Coding System. Using a […]

CPT: Medical Coding Roundtable: Why 99214 Is Your New BFF Code 99214 ranks as the second highest level of care for established patients, yet stands as one of the most underutilized codes out of the CPT book. It is commonly thought that physicians may down-code to a 99213, if the physician is not sure their […]

See this section in previous issues concerning ICD 9 and CPT coding The International Classification of Diseases is currently in its ninth edition and identifies 16,000 medical diseases or diagnosis. It is known as the ICD 9 and used by all physicians and surgeons. This is being up graded in the 10th edition to 68,000 […]

71 Percent of Obamacare Insurance Enrollment Gains Due to Medicaid New enrollment data for the second quarter of 2014 reveals how Obamacare enrollment shook out among Medicaid and private coverage. In all, the number of insured Americans increased by 8.5 million individuals. However, according to a new study from Edmund Haislmaier and Drew Gonshorowki of […]

Health Maintenance Organizations are becoming more aggressive in taking over the health care of the insured. They have unobtrusively sent physicians, who are not the patient’s personal physician, to visit our patients, interview them, examine them, do very detailed personal/social interviews, make various and sundry recommendations about their habits, medications, their diets, drinking, and other […]

Perverse Incentives There’s been a debate in Sacramento for the last 50 years concerning water that is purchased on the basis of the size of the pipe carrying it to your house. It was relatively inexpensive for a ¾ inch pipe that would easily take care of everyone’s water needs. The T-S-R (tax-spend-regulate) folks wanted […]

Having worked primarily in government hospitals for the first 12 years of my professional life, I knew very little about private health care. Medical school had a university hospital for all our clinical work. There were generally two services:  the ones that the resident/intern were primarily responsible for; and another for the professor’s private practice […]

Student Debt Linked to Worse Health and Less Wealth Those with over $50,000 in debt have lower well-being than debt-free peers by Andrew Dugan and Stephanie Kafka As college costs rise and enrollment increases, the amount of outstanding undergraduate student debt in the U.S. continues to climb. The amount of student debt now stands at […]

Margaret Mason came in complaining that her fingers were getting numb and she would like to see a neurologist. This was her introductory comment without the courtesy of waiting for her doctor’s diagnosis. Her friend already had given her the diagnosis. She had carpal tunnel syndrome and needed an operation and a neurologist was required […]

Medicaid savings in the January 2015 projection are due to 10 percent to 15 percent reductions in costs per beneficiary. The same holds for the $51 billion of savings due to lower subsidies to health insurers in Obamacare exchanges. CBO (Congressional Budget Office) notes that cost increases in private and government health plans have been […]