CMS’s IMM sends mixed messages to providers. The Important Message from Medicare (IMM) has changed significantly in its latest reiteration, and the IMM now must be presented to both Medicare…
Success can cost you more than you thought it would. You might have heard the phrase, “everyone wants to be successful until they see what it actually takes.” While I’m…
The coding of medical diagnosis and treatment has always been a challenging issue. Translating a patient’s complex symptoms, and a clinician’s efforts to address them, into a clear and unambiguous…
Hospital billing departments coordinate health plan benefits every day. Typically, coordination of benefits (COB) is aided by patient registration workflows that gather basic demographic and health insurance information. But what…
Question: I am aware that diagnosis codes for 2020 updated Oct. 1, 2019, but what about CPT codes? And do you have any information about codes that may affect acupuncture…
The American Medical Association (AMA) recently issued a checklist for physician practices to use when adopting evaluation and management (E/M) coding and documentation changes slated to take effect next year.…
Funding legislation aimed at keeping HHS and other non-Defense agencies running in fiscal year (FY) 2020 will also postpone $4 billion in Medicaid Disproportionate Share Hospital (DSH) payment cuts until…
While many people make plans for a new year, it's also time to prepare for the new 2020 Current Procedural Terminology (CPT) codes. That means reviewing CPT coding changes, learning…
Among the proposed new rules is one intended to clarify the contentious “Stark Law.” On Oct. 9, the Centers for Medicare & Medicaid Services (CMS) issued a proposed rule to…
Three risks, in particular, are expected to pose a greater liability for providers. As we get ready to say goodbye to another year of audits and investigations, compliance officers around…
WHY WE DID THIS STUDY We undertook this study because of concerns that Medicare Advantage organizations (MAOs) may use chart reviews to increase risk adjusted payments inappropriately. Unsupported risk adjusted…
Machine learning models can be trained to predict chronic diseases such as dementia using electronic medical record (EMR) data, according to a new study published in Artificial Intelligence in Medicine.…
In response to the recent occurrences of vaping related disorders and in consultation with the World Health Organization (WHO) Framework Convention on Tobacco Control, the WHO Family of International Classifications…
Sushovan Guha, MD, PhD, is a gastroenterologist and physician executive director at Banner Digestive Diseases Institute in Phoenix. He shared his thoughts on the uses of artificial intelligence in gastroenterology…
At the September meeting of the ICD-10 Coordination and Maintenance (C&M) Committee, members discussed ICD-10-CM proposals for codes for identification of specific synthetic opioids and revisions to the sepsis/severe sepsis…
It is important to understand the data needs for your organization from a content perspective as you prepare for ICD-11. As we talk about preparing for the transition from ICD-10…