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Coding for Medical Necessity 2019


Are you ready for civil penalties of up to $11,000 per billing error? Medical necessity errors, however unintentional, are being tried under the False Claims Act (FCA) as “knowingly false” acts—and losing in courts nationwide with thousands of dollars in civil penalties and exclusion from participating with Medicare.


If you aren’t prepared to pay the penalties, stay compliant and protect your revenue with Coding for Medical Necessity 2019.  Master how to integrate best practices for correct documentation, coding, and billing across specialties – and learn how to appeal denials even when you do everything right, and payers won’t comply.  


Get solid, real-world advice with examples, tools, Q&A, and expert guidance across specialties to master documentation, coding, and billing for medical necessity – including E/M services – and avoid audits. Conquer common coding errors, learn the ins and outs of documentation, and resolve common revenue-reducing problems to keep your practice profitable


Nail down medical necessity and get paid right the first time:

  • Find Out Why Medicare Advantage Claims are Under Scrutiny
  • Code by the Numbers for MDM
  • End E/M Coding Confusion With Payer Advice
  • Dodge Medical Necessity Errors With CERT Smarts
  • Your Diagnosis are Doing More Than Declaring Medical Necessity
  • 13 Expert Pointers to Fend Off RAC Audits, Denials
  • Check LCD, Payer Policies when Appealing Medical Necessity Denials
  • Document Necessity in This E/M-25 Encounter
  • Know How to Prove Necessity for Modifier 25
  • Don’t Be Surprised If RAC Review Is Around The Corner
  • Mind Modifiers for Repeat Chest X-Rays
  • Clip and Save: These Diagnoses Might Mean Facet Joint Injection
  • Use these 4 Pointers for Accurate Pressure Ulcer Coding
  • Refine Your Fracture Coding Using these 2 Guidelines
  • Prove Urine Test Medical Necessity With Accurate ICD-10 Codes
  • See How 'Medical Necessity' Factors into GI Surgery Pay
  • Dodge Denial Bullet with Arthrocentesis/Aspiration/Injection Advice
  • Incorrect Codes, Poor Notes, and Setting Debacles Add to E/M Fails
  • Getting Denied? Pay Attention to Procedure/Diagnosis Linkage
  • Your Diagnosis Choice Can Affect Your Pay
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