Published articles by Cristina Bentin, President
of Coding Compliance Management, LLC.

Maximizing Reimbursement and Staving Off Penalties through Oversight
Outpatient Surgery Magazine, July 2017. Your ASC is not only accountable for its actions but also the actions of its business partners providing services on behalf of your ASC. In the case of outsourcing, quite frequently an ASC develops an unhealthy - out of sight out of mind - complacency. It is necessary to establish internal controls with consistent monitoring of all aspects of the revenue cycle whether performed in-house or handled offsite by an independent central business office or billing company. Most ASCs understand that monitoring of its revenue cycle is essential but unfortunately, some fall short in execution. Consistent weekly/monthly internal audits of all aspects of the revenue cycle from A to Z should be conducted.

10 Best Practices for Establishing Internal Coding Audits
Becker's ASC Review, July 28, 2010. An existent compliance plan not only detects incorrect coding practices, it may also be considered by some federal agencies when determining whether reasonable efforts were taken to avoid and detect fraud and abuse. Let's look at the following 10 best practices for establishing internal coding audits at your ASC.

8 Key Points to Consider (and a Checklist to Use) When Selecting an External Coding Audit Company
Becker's ASC Review, July 27, 2010. ASCs should incorporate an external audit into their compliance programs. Formal coding audit protocol should define the purpose of the audit, frequency of review and sample size. The difficult part is selecting a credible auditing company. The interview process can be tedious, but remember, your final selection will impact your facility's bottom line. Consider the following key points when conducting your search.

Physician Queries Done Right
Outpatient Surgery Magazine, May 2010. How to ask a physician to clarify inconsistent or vague documentation. While most surgeons document the surgical procedures they perform in your facility with the utmost precision, there may be times when your coder needs clarification or additional documentation before she can assign the proper codes. When there's conflicting, incomplete or ambiguous information in the operative report, you must ask the physician to verify the procedure performed and to get any written clarification in the form of an addendum. The official name for this is a “physician query.” What it really means is, “Doc, we need you to clarify exactly what you did.”

How to Report Post-op Pain Blocks
Outpatient Surgery Magazine, October, 2009. Deciphering different post-op pain directives is key to getting the proper reimbursement. When it comes to getting paid for post-op pain blocks, not all payors require the same documentation and proof of medical necessity. Some commercial carriers follow the Medicare edits and guidelines while others don’t follow Medicare reimbursement — potentially allowing for more aggressive coding and reporting. Here's a review of different post-op pain directives.

5 Best Practices for Improved Coding of Orthopedic and Spinal Procedures
Becker's ASC Review, April 28, 2009. The reporting of orthopedic, spinal and pain management procedures continue to provide challenges for many ASCs regardless of whether the coder is a novice or a seasoned veteran. Below are five best practices to help ensure your facility captures reimbursement opportunities while adhering to coding guidelines.

News of note ...

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Thank you.

Cristina Bentin, CCS-P, CPC-H, CMA
President
Coding Compliance Management, LLC
AHIMA-Approved ICD-10-CM Trainer
225.752.8390