Ten Things About Oct. 1 That You Need To Know Now!

The 2017 Inpatient Prospective Payment System (IPPS) final rule brings with it a number of changes that are likely to have an even bigger impact on documentation, coding, and revenue than ICD-10 itself. An unprecedented number of dramatic changes will go into effect on Oct. 1. I knew that things were going to be interesting […]

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4 Medical Billing Issues Affecting Healthcare Revenue Cycle

Addressing these four common medical billing challenges can have a positive impact on the healthcare revenue cycle. Medical billing is the backbone of healthcare revenue cycle management, but many providers experience significant challenges with efficiently and accurately billing patients and payers for services they perform. Top four medical billing challenges impacting healthcare revenue cycle. The […]

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ICD-10 Pre-Bill Auditing a Growing Area of Concern

Given the massive number of new ICD-10 codes and the Oct. 1, 2016 compliance date, HRS and ICD10monitor are producing a special-edition Internet broadcast that will focus on the imperative of pre-bill auditing. The free broadcast will air live at 1:00 p.m. on Thursday, Aug. 4. The 60-minute live event is being sponsored by HRS. […]

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Office of Inspector General Gives Green Light to Hospice Provider’s Payment to Nursing Facilities

Last week, the Office of Inspector General, OIG, issued a favorable opinion to a hospice provider seeking to make supplemental payments to skilled nursing facilities. Under the proposed arrangement, the hospice provider would make a supplemental payment to the nursing facility for dual-eligible individuals electing the hospice benefit that would be in addition to and […]

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Understanding How EHR Use, Adoption Impacts Physicians

Many researchers have investigated the impact EHR use and EHR adoption has on physicians and hospitals, showing that the technology still has both pros and cons. Since the 2009 passage of the HITECH Act and the start of meaningful use, EHR adoption has become widespread throughout the healthcare industry. Despite the near ubiquity of EHR […]

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The Influence of a Specific Ophthalmological Electronic Health Record on ICD-10 Coding

Abstract Background A specific Electronic Health Record (EHR) for ophthalmology was introduced in an academic center in Germany. As diagnoses coding corresponding to the International Classification of Diseases Version 10 (ICD-10) is mandatory for billing reasons in Germany, we analyzed whether a change occurred in the diversity and number of diagnoses after the EHR introduction. […]

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World Health Organization Says Transgender is a Mental Illness

According to the World Health Organization, being transgender is a mental illness. But that could soon change, as the WHO prepares a new edition of the International Classification of Diseases (ICD), its global codebook that influences disease diagnostic manuals worldwide. The current version, ICD-10, was endorsed in 1990, and ICD-11 is due in 2018. The […]

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Reducing Your Risk and Staying the Course

One thing always remains the same in healthcare: change. With the implementation of ICD-10 we found out how disruptive some of these changes can actually be, and it appears that this was only a precursor to even more change in healthcare, with the implementation of new quality payment initiatives. During the ICD-10 implementation, we began […]

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Good News, Bad News: The Saga Continues

The long-awaited update to the CT lung screening national coverage determination (NCD) was finally released this month. As you may recall, current smokers who were otherwise eligible were omitted from the NCD-covered codes released last year. That is the really good news. The really bad news is that at least one Medicare Administrative Contractor (MAC) […]

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CMS Targets Heart Disease With New Program

More than 500 healthcare practices have been selected to participate in a new pilot program designed to prevent heart attacks and strokes in Medicare patients, the Centers for Medicare & Medicaid Services announced Thursday. The Million Hearts Cardiovascular Disease Risk Reduction Model is the latest idea from the CMS Innovation Center, which conceptualizes and tests […]

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How Physicians Can Improve Coding And Increase Revenue

Reimbursement for evaluation and management (EM) services is often the most challenging for primary care physicians and their billing staff. The most common EM codes are based on location, patient status, and level of service. A good understanding of the opportunities, and a review of common errors found in audits, will help your practice obtain […]

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Live Long and Prosper Under ICD-10-CM

If you are unfamiliar with the Star Trek brand, it began with a TV series in 1966 with William Shatner as Captain Kirk and Leonard Nimoy as Mr. Spock. They traveled the universe with the crew of the starship Enterprise and boldly went where no man has gone before! This beloved series is celebrating its […]

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Episodes of Care: The Future of Healthcare Payment?

The financing of healthcare is rapidly changing in this country. The Centers for Medicare and Medicaid Services (CMS) has introduced a wide array of value-based alternative payment models including bundled payments and shared savings through Accountable Care Organizations and Pay for Performance programs. The passage of the Medicare Access and CHIP Reauthorization Act (MACRA) includes […]

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Coding Impacts for Sepsis Revisions

The changing clinical indicators for sepsis have ignited a firestorm of debate at all levels of the healthcare industry. This month’s column provides a quick review of the changes and identifies three primary impacts to clinical coding as the new guidelines phase in. Comparing sepsis indicators The existing clinical indicators we have used for the […]

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Why It’s Essential That MACRA’s Start Be Delayed

This week at a hearing before the Senate Finance Committee, providers heard some comforting statements from Senate leaders and a key official from the Centers for Medicare and Medicaid Services. At the hearing, Andy Slavitt, acting administrator for CMS, said his agency was looking for ways to be flexible with the approach for enacting the […]

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FDA Officials Call For National Medical Device Evaluation System

Top officials at the U.S. Food and Drug Administration (FDA) have reiterated the need for a National Evaluation System for Health Technology (NEST) program that integrates data from clinical registries, electronic health records, and medical billing claims to gather more comprehensive evidence of medical device safety and effectiveness. NEST evolved out of a series of […]

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