lwconsulting

Improbable Day Scenarios for 1-1 Codes

Have you ever heard the term “improbable” day as it relates to coding and billing direct, one-on-one CPT Codes in Healthcare? You might be more familiar with the term “impossible day.” They both imply an improbable scenario of coding and billing volume in a given claim date based upon data analysis of payor paid claims. Based upon CPT Code definitions, attendance requirements, and clinician availability on a given claim date data analysis can flag providers…

How Do You Know if Your Therapists Are Coding Timebased Codes Accurately?

The recent self-disclosed conduct to the Office of the Inspector General (OIG) by Team Rehabilitation Services (TRS) is a reminder of the importance of proper coding by physical and occupational therapists. TRS agreed to pay over $12MILLION for allegedly violating the Civil Monetary Penalties Law. There were issues identified with improper billing for time-based codes and for the specific CPT code of 97164, the re-evaluation code. When coding time-based codes for Federal payors, or those…

A Malnutrition Diagnosis: From the Hospital to the SNF

The Answer to Understanding the Importance of Coding Accuracy   LW Consulting, Inc. (LWCI) strives to help clients with a variety of questions, queries, and concerns. The following blog explains the importance of coding accuracy with a malnutrition diagnosis specifically in the hospital as well as in the Skilled Nursing Facility (SNF). From the Agency for Healthcare Research and Quality, “Malnutrition among hospitalized patients remains a serious issue affecting more than 30 percent of hospitalized…