CPT Coding for Use of Operating Microscope (+69990)

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…

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CMS Proposes Payment Models for Surgical Procedures

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…

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Provider compensation rises again as groups push productivity

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…

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CMS OMH Marks Women’s Health Week with A Call to Action

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…

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Understanding Billing Requirements for Caregiver Training Services

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…

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Consideration postponed for new billing codes for prior authorization

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…

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Diagnosis Pitfalls to Look for When Seeking to Avoid Denials

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…

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The IPPS Proposed Rule Demonstrates the Importance of SDoH

The Centers for Medicare & Medicaid Services (CMS) has issued its 2025 Inpatient Prospective Payment System (IPPS) Proposed Rule, through which it proposes to change the severity designation for several…

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Proposed 2025 IPPS Rule: CMS Targets Readmission Metrics

When it comes to healthcare policy, even seemingly minor adjustments can have significant ripple effects across the industry. The Centers for Medicare & Medicaid Services (CMS) recently unveiled its proposed…

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