CMS Releases 331 New PCS ICD-10 Codes

New codes and guidelines become effective Oct. 1, 2023. The Centers for Medicare & Medicaid Services (CMS) published the ICD-10-PCS codes and guidelines for the 2023 fiscal year on May…

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Behavioral Health: To Screen or not To Screen?

How to stay compliant in behavioral health screenings. Behavioral health screenings aim to detect mental health symptoms in many seemingly healthy people. This can be done in various ways, including…

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How to Get a Medical Billing and Coding Job Promotion

Medical billing and coding is one of the hottest medical professions in great demand with a great deal of job opportunities and rooms for promotion. Promotion will come with increment…

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New CMS Initiatives Spark Interest

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…

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New CPT® Codes for Principal Care Management Services

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…

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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…

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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…

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The New York State Department of Financial Services wants health insurers to pay any extra bills when their out-of-date provider directories send patients to out-of-network doctors and hospitals.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

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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,…

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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…

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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…

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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…

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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…

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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…

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