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,…
Remote patient monitoring may be catching on with health systems across the country, but its path to Medicare reimbursement is still a work in progress. The Centers for Medicare &…
The AMA raised serious concerns about the lack of notice and short comment time frame for a new Occupational Safety and Health Administration (OSHA) regulation regarding measures that health care…
Medicare intends next year to allow physician assistants (PAs) to begin directly billing for their work and to expand coverage of telehealth services. It also intends to change the approach…
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…
CMS has proposed a new rule that would update the Medicare Physician Fee Schedule and seek more health equity and telehealth utilization among physicians. The proposed rule would establish a…
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…
Hospitals are advised to offer choice to patients in terms of nursing homes, home care agencies, long-term acute-care hospitals, and inpatient rehabilitation facilities. It has now been over 18 months…
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…