A new quarter began on Oct. 1, an event that usually brings updates to National Coverage Determinations (NCDs). The coding updates included for Oct. 1 are specified in Change Request…
Clinicians today are confronted with an increasing administrative burden alongside their patient care responsibilities, and a critical aspect of this burden is medical coding. This skill is crucial as it…
It’s certainly not breaking news that artificial intelligence (AI) is making inroads in healthcare. Nearly every new article on the topic seems to describe how AI is doing the work…
There has been growing interest in the intersection of utilization review (UR) and clinical documentation integrity (CDI). With greater recent changes, such as more UR and CDI staff going remote…
Using time to determine evaluation and management code levels THE AMERICAN MEDICAL ASSOCIATION (they own the CPT code set) in January of 2021 changed the criteria for determining the proper…
In the ever-evolving world of healthcare, medical coding plays a crucial role in capturing and organizing patient data for various purposes, including medical billing, research, and quality assessment. Coding medical…
This article was inspired by an article I read by Cynthia Tang and Richard Pinson (https://libmaneducation.com/coding-of-possible-malignancy-diagnoses-when-the-pathology-report-is-pending/). They expressed their concern about Coding Clinic’s advice to code an uncertain malignancy diagnosis…
Navigating the complex terrain of medical billing can be fraught with expensive and frightening pitfalls. From minor transcription errors to major coding misunderstandings, mistakes in this area can result in…
A proposed 3.3% cut to physician pay would threaten access to care and efforts to bring more clinical oversight into nursing homes, advocacy groups are warning. A 2024 draft pay…
A transformation is underway in medical coding as automation permeates medical billing. It raises many questions, such as what kind of skill sets will be needed for this new generation…
The U.S. Supreme Court ruled on a False Claims Act (FCA) case last week. As you probably know, the FCA makes it illegal for a healthcare provider to submit for…
The last several years have been tumultuous for the healthcare industry. Providers are continuing to face challenging profit margins, increased costs, staffing shortages and burnout. At the same time, consumers…
Amid the many challenges health care leaders face today, it can be easy to lose sight of some recent advances that could significantly change patient care. Here’s a look at…
Odds are, you are making these mistakes and missing out on revenue Q: What are the most common coding mistakes physicians make? A: As I work with providers across the…
The document will also be identified as CR 13136. The April 2023 Outpatient Prospective Payment System (OPPS) Update has been released and is effective April 1, 2023, and implemented on…
Several lawmakers are seeking to tie physician payment updates in Medicare to inflation to prevent potential physician shortage issues. Representatives Raul Ruiz, MD (D-CA-25), Larry Bucshon, MD (R-IN-08), Ami Bera,…