Not grandma’s CPT: Code set evolves amid pandemic, pay challenges

Mark Synovec, MD, chairs the CPT Editorial Panel, which is responsible for maintaining what is sometimes called “the language of medicine,” the Current Procedural Terminology (CPT®) code set. The Editorial Panel, he…

Comments Off on Not grandma’s CPT: Code set evolves amid pandemic, pay challenges

Introduction to the WHO’s ICD-11

Cluster coding is a new feature for coding professionals. The World Health Organization (WHO) began developing the International Classification of Diseases, Eleventh Version (ICD-11), in 2007, and first released a…

Comments Off on Introduction to the WHO’s ICD-11

New York proposes surprise billing crackdown

The New York State Department of Financial Services wants health insurers to pay any extra bills when their out-of-date provider directories send patients to out-of-network doctors and hospitals. The state…

Comments Off on New York proposes surprise billing crackdown

The Impact of Coding on Maternal Outcomes

This area of coding is not so easy. While most maternal deaths are preventable, the rate has been increasing in the United States since 2000. As a matter of fact,…

Comments Off on The Impact of Coding on Maternal Outcomes

ROI realized from pre-bill review of documentation and coding

Involving physicians in the mid-revenue cycle process can increase hospital ROI by 700%, according to Enjoin CEO Dr. James Fee. Hospitals and health systems can improve revenue through a pre-bill…

Comments Off on ROI realized from pre-bill review of documentation and coding

Medical Coding Slip at TX Hospital Led to COVID-19 Billing Error

Midland Memorial Hospital agreed to pay over $555,000 for a medical coding error that resulted in claims being sent out for reimbursement from the government even though patients did not…

Comments Off on Medical Coding Slip at TX Hospital Led to COVID-19 Billing Error

AI Has Long Way to Go to Be Helpful in Patient Care

Despite skepticism, artificial intelligence (AI) can be a boon for physicians…but some improvements are needed first. Notably, AI algorithms need to be validated, and bias toward particular groups of patients…

Comments Off on AI Has Long Way to Go to Be Helpful in Patient Care

Top Challenges, Opportunities of Medical Coding and Billing

By April of last year, seemingly every news station in American was featuring the heroic efforts of physicians, nurses, and other clinicians fighting COVID-19. These providers transformed healthcare, implementing telehealth…

Comments Off on Top Challenges, Opportunities of Medical Coding and Billing

Two Common Knee Ligament Injuries and Their ICD-10 Codes

Knee ligaments connect the bones and cartilage, and hold and support the knee joint. Any mild tear in ligaments may severely limit the movement of the knees. Most commonly occurring…

Comments Off on Two Common Knee Ligament Injuries and Their ICD-10 Codes

The ICD-11 Transition Timeline

After the tumultuous transition to the 10th International Classification of Diseases, simply saying the phrase “ICD-11″ is liable to strike fear in the hearts of medical providers across the country.…

Comments Off on The ICD-11 Transition Timeline

New Coding Rules for 2021

Betsy Nicoletti, MS, a nationally recognized coding expert, will take your coding questions via email and provide guidance on how to code properly to maximize reimbursement. Have a question about…

1 Comment

We are All One Exposure away from Contracting COVID-19

Sunday morning, I received an email from my father’s assisted living facility, indicating that several residents and staff had tested positive for COVID-19 during their newly implemented routine testing of…

Comments Off on We are All One Exposure away from Contracting COVID-19

Generalist Coders – A Fallacy

There is no such thing as a coder who knows it all. If your coder claims to be able to code every specialty, and you let them, you might want…

Comments Off on Generalist Coders – A Fallacy

3 Definitive Coding Answers to Bank Your Podiatry Pay

Podiatry coding is becoming increasingly complicated, and even the smallest reporting mistakes can lead to claim denials and reduced reimbursement. Worse, the stakes tend to escalate, with minor unchecked errors taking…

Comments Off on 3 Definitive Coding Answers to Bank Your Podiatry Pay