A new study from Mount Sinai suggests that using generative artificial intelligence to help with coding automation has some significant limitations. WHY IT MATTERS For the research, Mount Sinai's Icahn School…
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…
Chronic obstructive pulmonary disease, (COPD), is an overarching term for conditions which cause difficulty breathing, specifically from some type of impediment to air movement. The two main types are emphysema…
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…
An unprecedented number of individuals are now enrolled in Patient Protection and Affordable Care Act (PPACA) Marketplace health insurance plans – and federal officials this week signaled that the trend…
A recent proposal to report prior authorization to insurance plans through CPT codes was withdrawn at the eleventh hour when its physician advocate made an unexpected discovery: For certain codes…
As we begin the second half of the year, it is a convenient time to make plans and take stock of our coding operations. There will be much to do…
The new ICD-10-PCS codes for the 2025 fiscal year (FY) were posted on the Centers for Medicare & Medicaid Services website on June 6. The Version Summary reflects 371 new…
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.…
CPT code +69990 Microsurgical techniques requiring use of operating microscope is assigned when a surgeon uses an operating/surgical microscope to aid in visualizing small/fine structures in the operating field during…
The Centers for Medicare & Medicaid Services (CMS) has proposed an episodic payment model, the Transforming Episode Accountability Model (TEAM). This is one of CMS’s “innovation” models. If it makes…
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…
A recent study from the healthcare solutions company Premier indicated that $19.7 billion is what hospitals and health systems are spending annually on handling and appealing denials. Yes, that is…
The Centers for Medicare & Medicaid Services (CMS) has issued its 2025 Inpatient Prospective Payment System (IPPS) Proposed Rule, through which it proposes to change the severity designation for several…