The Centers for Medicaid and Medicare Services this week released a report on complaints and enforcement efforts concerning the Public Health Service Act, which includes the No Surprises Act. As…
If you have been listening to the discussions on Monitor Monday and Talk Ten Tuesday about the use of the new HCPCS code G2211, you know there remains some uncertainty…
In recent years, generative artificial intelligence (GenAI) has passed medical exams, diagnosed complex cases, and even come up with ways to combat a pandemic. In fact, large language models (LLMs) such as…
The proposed new Medicare billing codes in the proposed Physician Fee Schedule (PFS) for 2025 include three specific codes for digital mental health treatment (DMHT) relating to professional services involving…
The 60-day Refund Rule, created by the 2010 Patient Protection and Affordable Care Act (PPACA), requires providers to report and return Medicare and Medicaid overpayments within 60 days of identifying…
In the last 50 years, there have been significant developments that have forever improved the delivery of healthcare. Consider imaging (MRI/CT scans), minimally invasive surgery, anti-viral therapies, precision medicine (e.g.,…
Current treatment for traumatic arterial injury of the extremities consists primarily of replacement with autologous venous or synthetic graft. However, the need for emergent repair or the unsuitability of a…
The American Medical Association’s coding panel, which is responsible for creating medical billing codes, is set to meet September 19-21 in Albuquerque where it will consider yet another proposal to…
While CMS (the Centers for Medicare & Medicaid Services) usually releases new rules in the afternoon, on July 10 they chose to release the 2025 Outpatient Prospective Payment System (OPPS)…
Sea Chen, MD, PhD, remembers when his practice’s business office failed to notify others in the clinic about some denied claims and the reasons behind them. “Because of this, we…
In a landscape where patients are responsible for an ever-growing share of healthcare costs, traditional billing practices are falling short as consumers fall farther behind on their payments. Reversing this…
Most physicians wish they could spend less time writing clinical notes. But experts say that the time and energy needed to develop or learn to use new templates can discourage…
Excessive clinical documentation is a widespread problem that is causing clinician burnout and even having an impact on patient care – as an American Medical Informatics Association survey recently showed.…
As part of the Jan. 1, 2024 Outpatient Prospective Payment System (OPPS) guidelines, caregiver training services (CTS) codes were listed as billable services if provided by physicians and non-physician practitioners…
Medical experts have put on hold a proposal to create new billing codes for prior authorizations. The American Medical Association’s CPT (current procedural terminology) Editorial Panel was scheduled to meet…
Is there an arms race involving using technology for submitting claims and auditing them? In one example, an electronic health record system was deployed that would increase reimbursements. It would…