Quality Coding on a Shoestring Budget, aka Surfing for Success Websites Resources for Coders: http://www.aapc.com/resources/index.aspx Search Engines: http://www.google.com http://www.yahoo.com http://www.askjeeves.com http://www.hotbot.com http://www.bing.com http://www.codapedia.com/ http://www.med- ehub.com/home/tabid/36/default.aspx Medical Encyclopedias & Dictionaries: http://health.nih.gov/ http://www.nlm.nih.gov/ http://medlineplus.gov/ http://www.ama- assn.org/ama/pub/category/7140.html http://www.medscape.com/medscapetoday/resource http://www.instantanatomy.net/sitemap.html http://medical- dictionary.thefreedictionary.com/ Code Books: CPT https://catalog.ama- assn.org/catalog/cpt/cpt_search.jsp?_requestid=443758 http://www.ama- assn.org/ama/pub/category/3113.html CPT Assistant: https://catalog.ama- assn.org/catalog/product/product_detail.jsp?productid=prod170136?checkxwho=done Code Books: ICD- 9- CM http://www.cdc.gov/nchs/icd/icd9cm.htm http://www.cms.hhs.gov/icd9providerdiagnosticcodes American Hospital Association, Central Office on ICD- 9- CM http://www.ahacentraloffice.org Publisher of AHA Coding Clinic for ICD- 9- CM Publisher of Faye Brown s ICD- 9- CM Coding Handbook
Code Books: HCPCS http://www.cms.hhs.gov/medhcpcsgeninfo/ http://www.cms.hhs.gov/hcpcsreleasecodesets/anhcpcs/list.asp#topofpage E/M Documentation Guidelines: http://www.cms.hhs.gov/mlnedwebguide/25_emdoc.asp Be sure to print out the Evaluation & Management Services Guide. ICD- 9- CM Official Guidelines for Coding and Reporting: http://www.cdc.gov/nchs/icd/icd9cm_addenda_guidelines.htm http://www.cdc.gov/nchs/data/icd9/icdguide09.pdf Four Cooperating Parties for ICD- 9- CM: American Hospital Association (AHA) http://www.aha.org/ American Health Information Management Association (AHIMA) http://www.ahima.org/ Centers for Medicare and Medicaid Services (CMS) www.cms.gov National Center for Health Statistics (NCHS) http://www.cdc.gov/nchs/icd9.htm MPFSDB Medicare Physician Fee Schedule Database: http://www.cms.hhs.gov/physicianfeesched/ Click on PFS Relative Value Files Scroll down to bottom of page Click on Last Choose RVU10C_PCT22 (click on 2010 @ left) Click on RVUPUF10.pdf and print out Click on PPRRVU10_U22.zip, click Accept and then Open Double- click on PPRRVU10_U22 to open For GPCIs, click on GPCI10V2.zip, click Accept and then Open Double- click on GPCI10V2 to open A/B MAC Jurisdictions Fact Sheet: http://www.cms.gov/medicarecontractingreform/downloads/primaryabmacjurisdictionfactsheets.pdf
Palmetto GBA: http://www.palmettogba.com/palmetto/palmetto.nsf/docscat/home Click on J1 Part B MAC CA, HI, NV Click Fee Schedules under Top Links Click on 2010 June Medicare Part B Fee Schedule Update: Hawaii National Coverage Determinations (NCDs): http://www.cms.gov/mcd/overview.asp Click on Search Can search both NCDs and LCDs By document ID OR By geographic area & by key words in the title and/or CPT/HCPCS code http://www.cms.gov/mcd/index_list.asp?list_type=ncd#pv Alphabetical Listing For LCDs: Local Coverage Determinations http://www.cms.gov/mcd/index_lmrp_bystate_criteria.asp?error=a+state+must+be+selected% 2E By State http://www.cms.gov/mcd/index_local_alpha.asp?from=alphalmrp&letter=a Alphabetical Listing Correct Coding Initiative (CCI): http://www.cms.hhs.gov/nationalcorrectcodinited/ Scroll down and print the Modifier - 59 Article Click on NCCI Policy Manual for Medicare Services Click open and print Intro & TOC 1 st, then selected chapters, then close and scroll back up Click on NCCI Edits Physicians Save selected chapters to your computer Both Column 1 & Column 2 and Mutually Exclusive Rename by quarter Physician Quality Reporting Initiative (PQRI): http://www.cms.hhs.gov/pqri/ Pay for Performance (P4P): http://www.ama- assn.org/ama/pub/advocacy/current- topics- advocacy/private- sector- advocacy/practice- data- ranking/pay- for- performance.shtml http://www.aafp.org/online/en/home/policy/policies/p/payforperformance.html
Practice Administration Tools: www.cms.hhs.gov/center/practice.asp www.cms.hhs.gov/center/provider.asp www.cms.hhs.gov/center/physician.asp www.cms.hhs.gov/center/dme.asp www.cms.hhs.gov/center/hha.asp www.cms.hhs.gov/center/hospital.asp http://www.ama- assn.org/ama/pub/category/4555.html List Servs: http://www.cms.gov/aboutwebsite/emailupdates/list.asp CMS Coverage CMS Quarterly Provider Updates HIPAA Medigap News ICD- 10- CM Industry Email Updates http://www.cms.gov/icd10/02d_cms_icd- 10_Industry_Email_Updates.asp#TopOfPage HIPAA Compliance Plan: http://www.ama- assn.org/ama/pub/category/4234.html http://www.cms.hhs.gov/hipaageninfo/ http://www.hhs.gov/ocr/index.html OIG Compliance Program for Individual and Small Group Physician Practices: http://oig.hhs.gov/authorities/docs/physician.pdf Compliance Guidance on OIG website: http://oig.hhs.gov/fraud/complianceguidance.asp Compliance Resource Material on OIG website: http://oig.hhs.gov/fraud/complianceresources.asp OIG Annual Work Plan: http://oig.hhs.gov/publications/workplan.asp Recovery Audit Contractor (RAC) Audits: http://www.cms.gov/rac/
Regulatory & Compliance Issues: http://www.ama- assn.org/ama/pub/physician- resources/legal- topics/regulatory- compliance- topics.shtml Health System Reform Resources: http://www.ama- assn.org/ama/pub/health- system- reform/resources.shtml Contact your medical specialty society: http://www.ama- assn.org/ama/pub/about- ama/our- people/the- federation- medicine/national- medical- specialty- society- websites.shtml Contact your insurance commissioner: http://www.naic.org/state_web_map.htm Contact your elected officials: http://www.usa.gov/contact/elected.shtml