The Department of Justice is taking legal action against hospitals, health systems and technology companies for submitting false claims to Medicare and Medicaid pursuant to the Electronic Health Records Incentive…
If you’re an inpatient hospital coder, you’ve got some good news coming your way. Beginning on Oct. 1, 2019, you’ll have 1,322 fewer ICD-10-PCS codes to deal with. That’s because…
Value-based payment reform will be the key to lowering healthcare costs and improving care quality, according to health economist Michael Chernew, PhD. At AHIP’s 2019 Institute & Expo in Nashville…
When we started our medical billing enterprise in 1994 I had no prior experience at billing any medical claims, not to mention secondary and tertiary. I knew nothing. In fourteen…
It's no secret that today's generation of consumers is much different than 20 years ago (and even 10 years ago). Regardless of what we’re buying or who we’re engaging with,…
Understanding why there’s a need for auditing the auditors. I frequently encounter complaints by healthcare providers that when they are undergoing Recovery Audit Contractor (RAC), Medicare Administrative Contractor (MAC), and,…
CMS posted changes to the ICD-10-CM codes for fiscal year 2020. Five key points: 1. There were 71,932 ICD-10-CM codes for fiscal year 2019. The update includes 72,184 codes. 2.…
A recent study found that 25% of healthcare organizations don’t encrypt their patient’s data in the cloud. Sharing data is a crucial aspect in the doctor-patient relationship and keeping that…
Nearly eight billion smartphone users on earth and one billion in North America alone are increasing the focus of technologists and businesses towards this high-tech mobility. Smart device applications are…
The Patient Driven Payment Model is bringing new importance to the ICD-10-CM code set for SNFs. Here’s where the diagnosis codes will come into play. Get a Quick Overview of…
The purpose of D5994: Perio Protect is a prescribed medical device used to treat patients who suffer from periodontal disease. The device is lab-created and used as a “tray” to…
Coding is a major determinant of what dermatologists bill and what they get paid, so it’s critical to keep up with changes to be both compliant and accurate, says Mollie MacCormack, M.D., and…
In an effort to reduce healthcare disparities, the American Medical Association (AMA) recently vowed to support the creation of new alternative payment models that specifically address the outcomes of high-risk…
When the Patient-Driven Groupings Model (PDGM) launches Jan. 1, 2020, leveraging tools and resources to ensure compliance will be critical to a successful transition. Home health care providers already have…
Audits can be an unfortunate reality of practicing medicine. The good news is that as long as you are practicing and coding correctly, you have nothing to fear should you be audited. There…
That’s the contention of the Department of Health and Human Services’ Office of the Inspector General. An OIG audit discovered 34,664 Medicare claims that contained diagnosis codes indicating the treatment…