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Spelling Out Medical Necessity; Duplicative Coding

SPELLING OUT MEDICAL NECESSITY Q:  Does a diagnosis code alone support medical necessity for lab tests?  Shouldn’t there be something in the note documenting a sign/symptom or current status of the condition?  I do not think that by simple virtue of having a confirmed diagnosis that lab tests are always medically necessary. Best Medical Coding […]

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Zika: We Have a Code, and Other Updates

We have a code! The Zika virus has continued to generate national headlines. During this past week, it was announced that Zika can be transmitted through sexual contact as well as infected mosquitoes.

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ICD-10: Good For Starters But Much Work Ahead

As it was billed and touted, ICD-10-CM/PCS gives medical personnel vastly expanded powers of specificity when diagnosing diseases and other health issues. Yet that greatly enhanced specificity comes with a price tag—a transition period that some observers believed could be messy and disruptive.

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CMS Posts New Medicaid IT Resources

The Centers for Medicare & Medicaid Services has launched an online resource to support states’ efforts to update outdated IT systems, Andy Slavitt, CMS’ acting administrator, announced on Monday.

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Hiring crunch for coders leaves many providers unprepared as ICD-10 takes hold

Hiring Crunch For Coders Leaves Many Providers Unprepared As ICD-10 Takes Hold

After a number of delays, and much anticipation, the implementation of ICD-10 is finally underway as of Oct. 1. But with all the competition in the job market this year for skilled coding professionals, some hospitals and healthcare organizations may have yet to start the journey.

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Physicians Still Smiling Through Healthcare Changes: 6 key points

Physicians report they are still happy in light of healthcare changes, according to Physicians Practice’s 2015 Great American Physician survey. Kareo sponsored the survey. Here are six key points:

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Healthcare Providers In Mad Dash Towards ICD-10

With implementation of ICD-10 less than three months away, revenue cycle teams are breathing a little more easily since the Centers for Medicare and Medicaid Services’ announcement of a year’s grace period in which claims will not be denied because they’re not specific enough.

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Combating 3 Big Revenue Cycle Challenges

At Greensboro, NC-based Cone Health—a six-hospital, not-for-profit health system with 1,242 beds and gross annual revenue of $2 billion—a number of revenue pressures are making it tougher than ever to collect payment for services provided.

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Legislation to Delay ICD-10 Introduced

Physicians and other eligible professionals are expected to implement the International Classification of Diseases–10th edition (ICD-10) diagnostic coding system effective Oct. 1, 2015.

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ICD-10 Bill Surfaces, Calls For Delay, More Study Of Rollout Disruptions

Text of a bill by Rep. Ted Poe, R-Texas, to delay the switch to ICD-10 diagnostic coding surfaced on Monday, in which it requests further study on the disruption on healthcare providers could face resulting from the replacement of ICD-9.

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Leveraging The Clinical Data Warehouse For Accountable Care

Throughout this series, we explored how to create an integrated data asset through the integration of claims, clinical, financial and other data sources; how data from those sources is extracted; and how it’s organized between patient records in disparate systems.

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Physicians May Soon Be Paid For End-of-Life Discussions

The American Medical Association (AMA) has submitted codes that could finally lead to Medicare reimbursement for end-of-life and advanced care conversations, five years after a previous effort was squashed when the talks were labeled “death panels.”

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The Role of Claims Data in HealthIT: The Good, The Bad and The Ugly

As we move towards building a universal patient-centered data platform in health IT, several sources of data are useful.

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Postponed Billing System Causes Pain For M.D.s

A delay in requiring all providers of medical care to use a new health-records and billing system to describe treatments is giving small medical offices major headaches.

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Payers Respond to ICD-10 Delay

The questions came flying in from audience members during a recent broadcast of Talk Ten Tuesdays in which two payer representatives — Dennis Winkler from BlueCross-BlueShield of Michigan and Sidney Hebert with Humana —were interviewed.

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Two-Midnight Rule Will Short-Change Hospitals, Providers Say

Healthcare providers say Medicare is going to short-change them on patients who spend fewer than two nights in the hospital, and delaying implementation of a new payment policy until October won’t change that.

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