Marie Felger This is Me

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1. 1. www.memag.com

   www.memag.com/be_core/MVC?mag= - [Cached]

   Published on: 5/14/2004   Last Visited: 5/14/2004

   "Modifier -51 is straightforward," says Marie Felger, a certified coding instructor with Joy Newby & Associates in Indianapolis.

2. 2. Medical Newswire - Healthcare, Biotechnology News Release Service

   medicalnewswire.com/artman/pub - [Cached]

   Published on: 6/2/2003   Last Visited: 10/12/2004

   One of the biggest mistakes that physician coders make is reporting a simple laceration repair rather than an intermediate repair, says Marie Felger, CPC, a family practice coding consultant and American Academy of Professional Coders (AAPC)-certified coding instructor with Joy Newby & Associates LLC in Indianapolis. It's an error that can cost your practice revenue, not to mention the danger you create by not coding to the highest specificity, Felger warns.
   
   "Physicians often do not give enough information for coders to know whether an intermediate repair was performed," Felger says.
   ...
   If the documentation fails to mention the layered closure, the coder will miss that and report a simple repair code rather than the more accurate and higher-paying intermediate repair code, Felger says.
   
   2. Does Documentation Refer to Debridement?
   
   Another area your physician should include in chart notes is the extent of debridement he or she performs. Although intermediate repair usually requires layered closure, single-layer closure of heavily contaminated wounds that require extensive cleaning or removal of particulate matter also constitutes intermediate repair, according to CPT's repair (closure) notes.
   
   But many doctors forget to state that they performed decontamination or debridement of a large area, Felger says. In this case, she says the coder will not know that the repair qualifies for an intermediate repair and will instead use a simple repair code.
   
   For instance, after falling off his bicycle, a male patient presents with a 2.7-cm gash on his right knee and shin.
   ...
   The more complicated procedure will have more RVUs and a higher reimbursement rate than the less complicated procedure, Felger says.

3. 3. www.aafp.org

   www.aafp.org/online/en/home/pu - [Cached]

   Published on: 12/15/2005   Last Visited: 6/13/2007

   If a physician addresses three chronic diseases in a single patient visit, it usually -- though not always -- merits a 99214 level CPT code, according to FP Thomas Felger, M.D., of Granger, Ind. Felger teaches coding to residents as part of the practice management curriculum at the St. Joseph Regional Medical Center Family Medicine Residency Program in South Bend, Ind.
   
   Family physicians notoriously undervalue the services they provide, said Felger. It's not unusual for an FP to examine a complicated patient, prescribe six medications for three chronic diseases and then say, "Well, I didn't do very much for that patient" -- a perfect set-up for undercoding.
   
   The key to receiving appropriate payment for services rendered is careful documentation, said Marie Felger, C.P.C., C.C.S.P. who sometimes teaches coding courses alongside her husband. She said that if a physician is treating three conditions during a visit, all three must be addressed throughout the documentation, even if that documentation just indicates the condition in question is stable.
   
   "A treatment plan for each condition needs to be documented in the plan of care," Marie Felger cautioned, such as, "Continue exercise program for weight loss," or "Continue on asthma medication."