In recent years, generative artificial intelligence (GenAI) has passed medical exams, diagnosed complex cases, and even come up with ways to combat a pandemic. In fact, large language models (LLMs) such as…
The proposed new Medicare billing codes in the proposed Physician Fee Schedule (PFS) for 2025 include three specific codes for digital mental health treatment (DMHT) relating to professional services involving…
The 60-day Refund Rule, created by the 2010 Patient Protection and Affordable Care Act (PPACA), requires providers to report and return Medicare and Medicaid overpayments within 60 days of identifying…
Chronic obstructive pulmonary disease, (COPD), is an overarching term for conditions which cause difficulty breathing, specifically from some type of impediment to air movement. The two main types are emphysema…
In the last 50 years, there have been significant developments that have forever improved the delivery of healthcare. Consider imaging (MRI/CT scans), minimally invasive surgery, anti-viral therapies, precision medicine (e.g.,…
Current treatment for traumatic arterial injury of the extremities consists primarily of replacement with autologous venous or synthetic graft. However, the need for emergent repair or the unsuitability of a…
The American Medical Association’s coding panel, which is responsible for creating medical billing codes, is set to meet September 19-21 in Albuquerque where it will consider yet another proposal to…
The Centers for Medicare & Medicaid Services' (CMS') proposed calendar year 2025 physician fee schedule rule, out Wednesday, proposed an assortment of new payments and coverage for digital health services,…
An unprecedented number of individuals are now enrolled in Patient Protection and Affordable Care Act (PPACA) Marketplace health insurance plans – and federal officials this week signaled that the trend…
While CMS (the Centers for Medicare & Medicaid Services) usually releases new rules in the afternoon, on July 10 they chose to release the 2025 Outpatient Prospective Payment System (OPPS)…
Sea Chen, MD, PhD, remembers when his practice’s business office failed to notify others in the clinic about some denied claims and the reasons behind them. “Because of this, we…
A recent proposal to report prior authorization to insurance plans through CPT codes was withdrawn at the eleventh hour when its physician advocate made an unexpected discovery: For certain codes…
As we begin the second half of the year, it is a convenient time to make plans and take stock of our coding operations. There will be much to do…
In a landscape where patients are responsible for an ever-growing share of healthcare costs, traditional billing practices are falling short as consumers fall farther behind on their payments. Reversing this…
Most physicians wish they could spend less time writing clinical notes. But experts say that the time and energy needed to develop or learn to use new templates can discourage…
The Centers for Medicare & Medicaid Services (CMS) has announced that payments under the Accelerated and Advance Payment (AAP) Program for the Change Healthcare/Optum Payment Disruption (CHOPD) will conclude on…