Despite skepticism, artificial intelligence (AI) can be a boon for physicians…but some improvements are needed first. Notably, AI algorithms need to be validated, and bias toward particular groups of patients…
In the world of healthcare regulation, when it rains, it pours – but then occasionally, like last week, we get a drought. Last week, the Centers for Medicare & Medicaid…
Protect the integrity of your practice’s medical records with this sage advice. Evaluation and management (E/M) services are likely the most regulated and most often audited services in medical practices.…
States that expanded Medicaid in 2014 saw a 45 percent decline in the mean flow of medical debt collections compared to states that chose not to expand Medicaid or those…
On July 13, 2021, CMS released the 2022 Medicare Physician Fee Schedule Proposed Rule (Proposed Rule). In addition to the standard proposals related to rate setting for the coming year,…
The federal government is increasingly levying enforcement actions against health-care providers. For example, in fiscal year 2010, the federal government initiated 378 civil actions and 647 criminal actions, as compared…
The effective date for the FY 2022 Official Guidelines is Oct. 1, 2021 Released earlier in the year than in the past, the Official Guidelines for Coding and Reporting of…
Modern medical billing activities are complex, and it may take months to process a bill. Most issues crop up from internal workflow with demands forced by claims processing sellers as…
The billing Code 44 and the required UR process have become intertwined. Utilization review teams and physician advisors have the same goal as the Centers for Medicare & Medicaid Services…
OSHA has issued an Emergency Temporary Standard (ETS) for occupational exposure to COVID-19 that is applicable only to healthcare employers. The genesis for this ETS came one day after President…
The underlying etiology is sequenced first and the manifestation, or the presentation of the disease process, is coded second. Recently I was listening to a podcast called Coder vs. CDI…
Refinements continue for the evaluation and management (E/M) office-visit and outpatient documentation and coding reforms that took effect this year, and these include technical corrections updates to the Current Procedural…
The present world which we are working at right now is completely filled with far more opportunities to turn up everything right for ourselves. When we are progressing just in…
Medical necessity guidelines must also be carefully reviewed for their applicability to the individual patient. The term “medical necessity” is used far and wide in medical care. But medical necessity…
Many nursing home COVID-19 patients would have benefited from daily, reimbursed-for physician visits in their skilled nursing facilities, but they were not entitled to them. With an epic crisis still…
With dwindling provider availability and a growing patient population, the healthcare industry is increasingly turning to technological advancements to improve patient outcomes. During the pandemic, the industry was forced to…