The new ICD-10-PCS codes for the 2025 fiscal year (FY) were posted on the Centers for Medicare & Medicaid Services website on June 6. The Version Summary reflects 371 new…
The US health care industry continues a predominant fee-for-service provider reimbursement model, despite trying to shift to a value-based care model for now approaching two decades. Moreover, providers continue to…
A push to improve reimbursement for remote patient monitoring programs has stalled, and that could prompt health systems and hospitals to think twice about launching or expanding their platforms. The…
I recently saw a notable update on the Trusted Exchange Framework and Common Agreement or TEFCA, a federal program intended to improve health data interoperability across the healthcare industry. …
Excessive clinical documentation is a widespread problem that is causing clinician burnout and even having an impact on patient care – as an American Medical Informatics Association survey recently showed.…
CPT code +69990 Microsurgical techniques requiring use of operating microscope is assigned when a surgeon uses an operating/surgical microscope to aid in visualizing small/fine structures in the operating field during…
The Centers for Medicare & Medicaid Services (CMS) has proposed an episodic payment model, the Transforming Episode Accountability Model (TEAM). This is one of CMS’s “innovation” models. If it makes…
Provider compensation is still on the rise after the COVID-19 pandemic, according to the latest data from the Medical Group Management Association (MGMA). For the fourth consecutive year, MGMA recorded…
Federal officials are marking National Women’s Health Week with a call for awareness and reform to address stubborn disparities that have lingered historically – and to this day lead to…
A physician private practice with a good handle on its revenue cycle can bring in more dollars and adapt more quickly to external forces such as lower payment rates. It…
As part of the Jan. 1, 2024 Outpatient Prospective Payment System (OPPS) guidelines, caregiver training services (CTS) codes were listed as billable services if provided by physicians and non-physician practitioners…
Medical experts have put on hold a proposal to create new billing codes for prior authorizations. The American Medical Association’s CPT (current procedural terminology) Editorial Panel was scheduled to meet…
Medicare Advantage plans have come under fire for upcoding that can increase the payouts they receive, and regulators point to health risk assessments as a likely culprit in this increase…
Is there an arms race involving using technology for submitting claims and auditing them? In one example, an electronic health record system was deployed that would increase reimbursements. It would…
The rapid adoption of telehealth services, accelerated by the COVID-19 pandemic, has had a positive result on outcomes and resulted in a boost in healthcare spending, according to a report…
A recent study from the healthcare solutions company Premier indicated that $19.7 billion is what hospitals and health systems are spending annually on handling and appealing denials. Yes, that is…