Businesses, counties and municipalities could see a potentially significant increase in workers’ compensation benefits under legislation introduced in the House of Representatives involving permanent partial disability awards that have been…
SPELLING OUT MEDICAL NECESSITY Q: Does a diagnosis code alone support medical necessity for lab tests? Shouldn’t there be something in the note documenting a sign/symptom or current status of…
No doubt, electronic health records still are in need of improvement. That said, there's no denying the inroads they're making in research. Recent reports we highlight this week really highlight…
One of the things we are worried about is how ICD-10 implementation affects reimbursements for healthcare providers. And since Oct. 1, we've saying it's too early to tell. That's mostly because…
As it was billed and touted, ICD-10-CM/PCS gives medical personnel vastly expanded powers of specificity when diagnosing diseases and other health issues. Yet that greatly enhanced specificity comes with a…
Unreliable provider communication leaves patients vulnerable to expensive and potentially harmful medical errors, delays the medical billing process, and distorts quality of care. Reducing claims reimbursement waste demands a closer…
"Upcoding" means reporting a higher-level service or procedure or a more complex diagnosis, than is supported by medical necessity, medical facts, or the provider's documentation. For example, reporting a diagnosis…
Z23. That’s the ICD-10 billing code for an immunization encounter. It’s also the only code that stumped the team at Arlington, Virginia-based Privia Health, a national medical group. “It’s a…
After months studying a growing balance billing problem, Pennsylvania Insurance Commissioner Teresa D. Miller suggests patients should be removed from the dispute. In a public comment period that ends Feb.…
2016 may be a big year for revenue cycle management. Healthcare organizations see steady claims denial post-ICD-10 implementation and remain focused on value-based care models. Healthcare organizations are focused on strengthening revenue…
The Centers for Medicare & Medicaid Services has launched an online resource to support states' efforts to update outdated IT systems, Andy Slavitt, CMS' acting administrator, announced on Monday. Through…
Reimbursement for procedures is an ASC's bread and butter. Here are eight things to know about surgery center reimbursement. 1. Surgery center reimbursement comes from several sources, according to the…
Say goodbye to the server, the future of health technology lies in the cloud. Thanks to advances in security and reliability, affordable web-based technology is more popular with physicians than…
In the wake of the Oct. 1 transition to ICD-10, very few issues have surfaced. However, providers and billers have experienced difficulty with coding for medical necessity, receiving denials due…
Poor documentation, decrease in productivity among main ICD-10 challenges thus far. Leading up to the healthcare industry’s transition to the ICD-10 coding set on Oct. 1, 2015, there seemed to…
“They’d only take ‘sequela’ or they’d only take ‘subsequent,’ and it was not necessarily understood what those seven characters meant." Lack of training for inpatient procedural coding may pose a…