In 2021, the Centers for Medicare & Medicaid Services (CMS) issued guidance to emphasize the importance of social, economic, and environmental factors that can affect the health outcomes of disadvantaged…
New guides become effective Oct. 1, 2022. It’s time to review the Official Guidelines for Coding and Reporting for fiscal year 2023. These take effect Oct. 1, 2022, and reflect…
The proposed rule includes expansions to the Physician Payment Schedule as well as a focus on access to high-quality care. The Calendar Year 2023 Physician Fee Schedule (PFS) proposed rule,…
A new survey of physicians finds they are still facing burdens meeting prior authorization requirements despite a voluntary 2018 agreement among payer groups to reform the practice. The survey was…
The rising cost of healthcare in the United States has left consumers feeling lost and overwhelmed. High deductible healthcare plans, co-pays, and out-of-pocket medical expenses have all contributed the emergence…
June 30, 2022 William N. Parham, III, DirectorPaperwork Reduction StaffOffice of Strategic Operations and Regulatory AffairsCenters for Medicare & Medicaid Services7500 Security BoulevardBaltimore, Maryland 21244 Re: Provider Complaints Submission Process…
Despite myths to the contrary, physicians are not prohibited from coding and billing for both preventive and problem-focused evaluation and management (E/M) services when they are performed during the same…
New codes and guidelines become effective Oct. 1, 2023. The Centers for Medicare & Medicaid Services (CMS) published the ICD-10-PCS codes and guidelines for the 2023 fiscal year on May…
Are you using something other than two-midnight? Here’s why you shouldn’t be. Is there the possibility that your utilization management team and physician advisors are applying InterQual, MCG, or any…
Just when you think your practice is running without a hitch, it happens. You receive notice of an audit from one or more of your payors, demanding detailed records on…
How to stay compliant in behavioral health screenings. Behavioral health screenings aim to detect mental health symptoms in many seemingly healthy people. This can be done in various ways, including…
The Department of Health and Human Services is announcing a funding opportunity of nearly $15 million for a three-year federal grant to establish a Substance Abuse and Mental Health Services…
Medical billing and coding is one of the hottest medical professions in great demand with a great deal of job opportunities and rooms for promotion. Promotion will come with increment…
Some flareups may lead to readmissions within 30 days. We can all agree that we want to fully treat our patients’ acute problems that require inpatient hospitalization, allowing them a…
Choosing a proper office visit code can become confusing unless one understands the rules separating preventive medicine and evaluation and management (E&M) coding. Problem-oriented E&M services, office, and other outpatient…
You might know that medical billing is a challenging process. That’s the reason why many people make several mistakes in this case. If you have the same problem, you can…