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Improving the Health of Your Practice

Revenue Management

Aultman MSO offers comprehensive accounts receivable management services, along with reporting capabilities.

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Information Systems

Aultman MSO provides local information systems support to all clients with one number to call for any system-related problems.

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Consulting & Education

Aultman MSO is committed to providing a variety of education opportunities for providers and their staff.

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Coding & Compliance

With the implementation of ICD-10-CM, Aultman MSO is here to help with the transition.

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Credentialing

Let the Aultman MSO credentialing specialists provide credentialing services for you and help to ease the enrollment process.

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Information Systems

Aultman MSO provides local information systems support to all clients with one number to call for any system-related problems.

Learn More

Consulting & Education

Aultman MSO is committed to providing a variety of education opportunities for providers and their staff.

Learn More

Coding & Compliance

Aultman MSO has a staff of certified coders here to answer your questions, along with an offering of ICD-10-CM educational classes for your office.

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Credentialing

Aultman MSO is here to assist providers with the preparation and maintenance of initial insurance credentialing paperwork.

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Diagnosis Codes on Professional Claims

In reference to the number of diagnosis codes submitted on professional claims, Aultcare and Primetime would like to remind physician offices to follow the Official ICD-9-CM Guidelines for Outpatient Coding and Reporting. Specifically, the guidelines in subsections H, J, and K in Section IV: Diagnostic Coding and Reporting Guidelines for Outpatient Services. The guidelines outlined in this section will also be the same for ICD-10-CM.

H: ICD-9-CM code for the diagnosis, condition, problem, or other reason for encounter/visit

List first the ICD-9-CM code for the diagnosis, condition, problem, or other reason for encounter/ visit shown in the medical record to be chiefly responsible for the services provided. List additional codes that describe any coexisting conditions. In some cases the first-listed diagnosis may be a symptom when a diagnosis has not been established (confirmed) by the physician.


J: Chronic diseases

Chronic diseases treated on an ongoing basis may be coded and reported as many times as the patient receives treatment and care for the condition(s).


K: Code all documented conditions that coexist

Code all documented conditions that coexist at the time of the encounter/visit, and require or affect patient care treatment or management. Do not code conditions that were previously treated and no longer exist. However, history codes (V10-V19) may be used as secondary codes if the historical condition or family history has an impact on current care or influences treatment.


The 837P electronic claim format allows for 10+ diagnosis codes and payers, in general, would like to be able to identify conditions for HEDIS, PQRS, and VBPM measures. Any additional codes that describe coexisting conditions, chronic diseases treated on an ongoing basis, can be coded as many times as the patient receives treatment and care for the condition(s).

Updates

Medicare 60-Day Repayment Rule

02-25-16

On February 12, 2016 the Centers for Medicare and Medicaid Services (CMS) published a final regulation regarding the 60 day repayment rule.

EFFECTIVE JAN. 1, 2016: MEDICARE ADVANCE CARE PLANNING SERVICES

12-03-15

Beginning on Januray 1st, 2016 physicians and other practitioners will be able to bill out two separate CPT codes for advance care planning (ACP).

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