Many readers may remember the Centers for Medicare & Medicaid Services (CMS) Transmittal 534. This was released in early August 2014, and it would have given Medicare contractors the ability…
Just like our patients, proper coding and billing for obstetric patients can be…complicated. As a coding instructor and compliance auditor, I field a lot of questions from new students and…
In an era of value-based reimbursements, rising overheads, changing codes, and increased scrutiny of claims by health insurance companies, dermatology medical billing and coding has become quite complex. Dermatology practices…
Incident to billing allows non-physician providers (NPPs) to report services “as if” they were performed by a physician. The advantage is that, under Medicare rules, covered services provided by NPPs…
Improving revenue cycle management is a key focus for hospitals and health systems as they navigate the shift to value-based care and patients take on more financial responsibility for their…
The Centers for Medicare & Medicaid Services (CMS) has removed two Healthcare Common Procedure Coding System (HCPCS) codes just days before the bid window opens. Codes E0992 and K0056 have…
The shift to value-based care has driven public and private payers to redesign reimbursement models that stress accountability for care quality and healthcare costs. As the fee-for-service environment fades away,…
Innovaccer, which develops data tools to help health systems with accountable care and population health management, has published a new research paper focused on the ways advanced machine learning algorithms…
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,…
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…