Q: Is reporting of Current Procedural Terminology (CPT) codes 99218-99220 restricted to a single physician? A: According to CPT guidelines, only the physician or non-physician practitioner (NPP) placing the patient…
Artificial intelligence. The tech industry is just so enthusiastic for it and with good reason. As if the ability to process immense amounts of data wasn’t already good enough, the…
The Centers for Medicare & Medicaid Services (CMS) recently published the 2020 Medicare Physician Fee Schedule (MPFS) Proposed Rule. While many issues are included in the 1,700-page rule, three are…
Denials are a source of frustration for all physicians. When left unmanaged, they’re also one reason why physicians ultimately sell or close their practices, says Dorothy Steed, CCS, CDIP, revenue…
G71.01 is, literally, the code for Duchenne muscular dystrophy. Q93.51 stands for Angelman syndrome, and G40.419 covers generalized and treatment-resistant epilepsies, which groups like Orphanet and the American Epilepsy Society define…
Say goodbye to RUG-IV, and hello to the Patient-Driven Payment Model (PDPM). This is a daunting task, not for the faint of heart. Under PDPM, reimbursement for Medicare Part A…
It takes between 50 and 90 days after a claim is submitted for a medical practice to receive an insurance payment (excluding patient copays).Healthcare providers usually don't receive the full…
Hospital compliance programs have the potential to prevent costly denials and healthcare fraud investigations by conducting audits of high-risk areas, including coding, clinical documentation, and medical billing. Yet hospitals are…
Last week, the 11th Circuit (the federal appeals court for the Southeastern United States) issued a decision in the AsceraCare case. We have been waiting for this decision since…
Physicians work hard to generate revenue, and with slim operating margins, they don’t want to contend with costly recoupments. Compliant coding and billing helps them avoid the focus of a…
The Centers for Disease Control and Prevention (CDC) is currently investigating vaping-related illnesses that have recently been reported. There are 450 confirmed or suspected cases in 33 states. The first…
It is estimated that as high as 80 percent of medical bills contain errors.1 As healthcare costs continue to rise, so too is the need for healthcare payers to reduce…
The Centers for Medicare & Medicaid Services (CMS) issued a final rule on September 5, 2019, intended to address program integrity and vulnerability issues. The Office of the Inspector General…
Using automated deep learning software, physicians without any background in computer programming were able to develop effective artificial intelligence technology for medical image diagnostic classification, a recent study found. As…
Expect more aggressive reviews of materials beyond the three-day criteria. Today I want to talk about skilled nursing facility, or as we often call them, “SNF” stays. For this, I’d…
Santa Monica, Calif.-based Oceanside Medical Group failed to comply with Medicare requirements when billing for psychotherapy services, according to a report from HHS' Office of Inspector General. The OIG said…