CMS Tackles Opioid Prescribing

The Centers for Medicare & Medicaid Services (CMS) intends to align its Medicare plans, including Part D prescription plans, with the Centers for Disease Control and Prevention (CDC) opioid prescribing…

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CMS Exempts Two Thirds of Clinicians From MIPS

The Centers for Medicare & Medicaid Services (CMS) has exempted about two thirds of physicians and other clinicians who provide care to Medicare beneficiaries from the Merit-based Incentive Payment System…

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3 Best Practices for Hospital Claim Denials Management

Implementing claim denials management best practices is key to ensuring hospitals maximize claims reimbursement revenue and prevent denials. Healthcare cost control continued to top hospital priority lists in 2017. But…

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ICD-10 Coding Questions Answered

Q: One of our physicians is getting conflicting information regarding the ICD-10 codes E66.01 and E66.9. We have been coding E66.9 for Body Mass Indexes (BMIs) between 30-34 and E66.01…

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Computer Assisted Coding Anticipated To Grow To $2.5 Billion By 2023

Physician Computer Assisted Coding Market for Professionals Report 2017-2023 provide Industry shares, strategies, analysis and forecasted Computer Assisted Coding Market to reach $2.5 billion by 2023. Report also provides Research…

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Feds Crack Down on Upcoding

By the time the late President Lyndon B. Johnson signed the law establishing Medicare and Medicaid in 1965, the health care community was already figuring out how to maximize its…

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Read more about the article Humana Refines Diabetes Risk Stratification Tool Using ICD-10
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Humana Refines Diabetes Risk Stratification Tool Using ICD-10

The ICD-10 transition provided Humana with the "perfect opportunity" to develop a more detailed diabetes risk stratification tool. In an effort to improve the delivery of targeted chronic disease management…

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Healthcare Hotbed for Fraud Cases

While it might surprise some folks that five Modesto doctors are among those facing fraud charges in a $40 million medical billing and kickback case based in Southern California, it…

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When Practices are Too Cautious about HIPAA

Many providers have the belief that HIPAA should be treated like well-regarded advice from your mom: It's better to be safe than sorry. But that mentality is not always the…

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ICD-10 Diagnosis Codes That Identify Weeks Gestation of Pregnancy

ICD-10 Diagnosis Codes that identify weeks gestation of pregnancy and birth weight requirement when billing a delivery CPT Procedure Code Effective for Dates of Service beginning January 1, 2017, and…

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CMS Told To Crack Down On Improper Medicaid Payments

The Centers for Medicare & Medicaid Services needs to step up its involvement in states' Medicaid integrity programs in order to strengthen oversight and identify overpayments, according to a new…

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14 Things To Know About Medical Coding

Medical coders play a crucial role in the revenue cycle process, as they help ensure health systems, hospitals and physicians are properly reimbursed for the services they provide. Here are…

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Clearing Up Confusion Over ICD-10-CM Guidelines

The Health Insurance Portability and Accountability Act (HIPAA) requires covered entities to adhere to the most current International Classification of Diseases, 10th Revision, Clinical Modification (ICD-10-CM) code set as well…

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Key ICD-10 Changes That Impact Pathology/Lab Coding in 2017

Have you updated your reporting of malignant carcinoid tumors, viral hepatitis, GIST or ovarian cyst coding? You haven’t had to deal with annual ICD-10-CM updates until Oct. 1, 2016. Now…

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What Should Hospital Administrators Concentrate More On?

Hospital administrators have to juggle between various tasks like managing finances, projects and the usual daily hospital operations. To top it all, the priorities are constantly changing from one department…

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ICD-10 Codes Aren’t Oppressive After All

Alexander Miller, M.D., a dermatologist in Yorba Linda, Calif., has a simple message for colleagues grappling with the new ICD-10 codes: Don't panic! "It's just a matter of restructuring one's…

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