Table 1.

Ten HPM Billing and Coding Fixes to Implement this Week

FIX 1:	Remember that D in ICD is for disease and P in CPT® is for procedure.
FIX 2:	For employed palliative care clinicians, notice whether the clinical revenue attributed to you includes only your work RVUs or whether it includes the total RVUs generated by your care; the higher total RVUs better reflect your financial impact on your organization.
FIX 3:	If you are being measured by your health system, ask for your collections as a percentage of the Medicare Fee Schedule and not as a percentage of your hospital's Charge Master; if you are setting Charge Master prices for your organization, know the Medicare payment and exceed it.
FIX 4:	Gain an understanding of E&M rules and on which types of patients E&M coding is more likely to capture the complexity of the service you provide, regardless of time spent.
FIX 5:	Use the chief complaint section to document the medical necessity for your visit.
FIX 6:	Document the medically appropriate key component of the visit personally performed to satisfy APP split-share documentation; we recommend that is the personally performed physical exam.
FIX 7:	Palliative care providers should report the ICD-9 code for the symptoms treated, allowing the referring provider to code for the underlying disease.
FIX 8:	Ensure your primary Medicare Specialty Code is updated to accurately reflect your current clinical practice; HPM is specialty code 17.
FIX 9:	Remember that a 4-point HPI, a 10-point review of systems, past medical, family, and social histories are ALL required for moderate and high-level new consults and admission/observation stays in the hospital. To use a simple football analogy, remember 4th and 10.
FIX 10:	Know that your level of personally documented information increases dramatically when working with unlicensed student providers; they can only provide review of systems and past medical, social, and family history.