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…
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…
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…
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…
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…
Ask your carriers how they want these surgeries reported to avoid reduced reimbursement. Spine surgeons who perform bilateral surgeries such as lumbar laminotomies (63030) should append modifier 50 (Bilateral procedure)…
Addiction services may be a societal necessity – especially as the Central Massachusetts opioid crisis proves particularly fatal – but it is a business, and in this area of medicine,…
A new year means new codes and new revenue opportunities for medical practices—but also new challenges to ensure the codes are used correctly. Below is a brief summary of new…
MIPS Eligible Clinicians can opt to report as individuals or as a group. A group is defined by the Tax Identification Number (TIN). If you choose this option, the group…
Radiology, as a business, has become increasingly complex as regulatory demands grow and revenues, both on the hospital and physician side decrease. Doing more with less has become a common…
The International Classification of Disease is perhaps one of the most important diagnostics documents in the medical world. It categorizes diseases and medical incidents that can be encountered, and the…
New technologies need new codes CPT codes describe medical, surgical and diagnostic services and procedures. These codes communicate uniform information about medical services and procedures to healthcare providers, payers, administrators…
In 2016, the federal government recovered more than $3.3 billion in healthcare fraud judgments and settlements. On Monday, TeamHealth agreed to pay $60 million to settle allegations that a company…
With the change in payment focusing on quality medicine instead of the old-fashioned fee for service, providers better be savvy with their coding or they will lose out on the…
CMS has announced a glitch in the quality reporting measures brought upon by the changes in the ICD-CM (Clinical Modification) and ICD-PCS (Procedural Coding System) updates that went into affect…
Five tactics to educate physicians and improve documentation. Q: Our coders and coding auditors often see patterns of incorrect physician documentation. Sometimes the error impacts the MS-DRG, but many times…