The Accountable Care Organization (ACO) Realizing Equity, Access, and Community Health (REACH) initiative is a new model for ACOs operating under Medicare. It will be tested under the Centers for…
These codes are time-based CPT codes, used to report care management activities during a calendar month. The Centers for Disease Control and Prevention (CDC) reports that 6 in 10 Americans…
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…
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…
The New York State Department of Financial Services wants health insurers to pay any extra bills when their out-of-date provider directories send patients to out-of-network doctors and hospitals.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…
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,…
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…
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…
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…
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…
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…
According to published results, orthopedic residents who received formal medical coding education better identified proper billing codes for common procedures compared with residents who received no coding education. Researchers at…
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.…
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…
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…
Most of the physicians lose a significant amount of revenue every year due to minor and major mistakes that cause errors while filing medical claims. A minor write-off in physician…