CMS has provided ICD-10 Procedure Coding System updates for the fiscal year beginning Oct. 1, 2019, and ending Sept. 30, 2020. Four takeaways: 1. The updated ICD-10-PCS codes are for…
Tina R. Strawn, RN, administrative director of operations for patient financial services at Houston-based Harris Health System, has 27 years of healthcare experience. Throughout her career, she has worked in…
It’s every physician’s worst nightmare: Receive payment for services rendered, but then a payer identifies an aberrant pattern in claims data, audits the records, decides it has overpaid the practice,…
Another day, another change to E/M plans for 2021! Medicare has released the 2020 proposed rule for the Medicare Physician Fee Schedule (MPFS), bringing in the recent AMA plan to…
Advance-care planning (ACP) is the keystone of goal-concordant care, enabling patients to state their treatment preferences while they still have the mental capacity to do so. The Centers for Medicare…
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…