Often called the “language of medicine,” the Current Procedural Terminology (CPT®) code set is always evolving, and one reason for that evolution is to lower the administrative burden for physicians and their…
There are over 300 changes you need to know. KEY TAKEAWAYS Knowledge of coding updates is essential for everyone from the biller to the revenue cycle leader. The 2024 CPT…
This article was inspired by an article I read by Cynthia Tang and Richard Pinson (https://libmaneducation.com/coding-of-possible-malignancy-diagnoses-when-the-pathology-report-is-pending/). They expressed their concern about Coding Clinic’s advice to code an uncertain malignancy diagnosis…
Navigating the complex terrain of medical billing can be fraught with expensive and frightening pitfalls. From minor transcription errors to major coding misunderstandings, mistakes in this area can result in…
A proposed 3.3% cut to physician pay would threaten access to care and efforts to bring more clinical oversight into nursing homes, advocacy groups are warning. A 2024 draft pay…
A transformation is underway in medical coding as automation permeates medical billing. It raises many questions, such as what kind of skill sets will be needed for this new generation…
The U.S. Supreme Court ruled on a False Claims Act (FCA) case last week. As you probably know, the FCA makes it illegal for a healthcare provider to submit for…
The last several years have been tumultuous for the healthcare industry. Providers are continuing to face challenging profit margins, increased costs, staffing shortages and burnout. At the same time, consumers…
The pace of innovation is picking up as health IT vendors seek to integrate artificial intelligence into their offerings for provider operations, medical testing, patient engagement and other use cases.…
The American College of Rheumatology (ACR) commended CMS for its proposed prior authorization policies but asked the agency to expand its guidance to other utilization management tools and shorten the…
Outpatient visits are being billed at higher levels, leading to increased healthcare spending and concerns about upcoding, a Peterson-KFF Health System Tracker found. Healthcare providers can bill outpatient evaluation and…
Following a recent US District Court ruling on the federal government’s arbitration process for disputed medical billing—making the protocol for issuing decisions on disputed claims unclear—CMS posted some clarifying guidance…
CMS proposes new rules for 2024 that apply to Medicare Advantage Plans. Last month, I told you that there would be big news coming, and sure enough, there was. The…
When commenting on the Medicare Hospital Outpatient Prospective Payment System (OPPS) and Ambulatory Surgical Center (ASC) Payment System proposed rule for calendar year (CY) 2023, the American Hospital Association (AHA)…
CMS has specific guidelines when defining “incident to” and shared visits. Recently, I was working with a client to help them understand “incident to” billing. We were discussing a situation…
The American Medical Association has issued a category III current procedural terminology code for Figur8's sensor fusion system combining inertial measurement system and surface mechanomyography. The device was designed to…