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…
A new collaboration between the AMA and UnitedHealthcare will work to address the social and environmental factors that affect patients’ health by standardizing data collection on their social determinants of…
Modifiers are the key to overriding Correct Coding Initiative (CCI) edits, so let’s give them the attention they deserve. We’ll start with a recent rule update and move on to…
Although International Classification of Diseases, Tenth Revision, Clinical Modification (ICD-10-CM) took effect on Oct. 1, 2015, there still are many gaps in the understanding and use of the code set.…
CMS has provided ICD-10-CM coding updates for fiscal year 2020 that include 273 additions 21 deletions and 30 revisions, according to the American Health Information Management Association. The 21 deletions for the fiscal year…
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…
You might think that you could rely on the accuracy of a Medicare Administrative Contractor (MAC) policy, but apparently, you can’t. First, I’d like to extend thanks to my colleague…
After the tumultuous transition to the 10th International Classification of Diseases, simply saying the phrase “ICD-11″ is liable to strike fear in the hearts of medical providers across the country.…
At the annual Fujitsu Innovation Gathering today in London, Fujitsu Laboratories of Europe today announces a new AI technology that enhances Electronic Health Record (EHR) management, automating the processing of unstructured (free text)…
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…
Are you exhausted? Feel cynical toward your job? Tell your boss that you are part of an occupational phenomenon called burnout. But maybe don’t mention it’s in the same category…
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,…