Seniors often found out only when they got surprise bills for the services Medicare doesn’t cover for observation patients. Under a new federal law, hospitals across the country must now alert Medicare patients when they are getting...
More InfoThe Louisville-based Humana is expanding a value-based payment model into seven additional states, while the Medicare agency has yet to set a clear course for how to handle such models. Humana announced last week it would start offering its...
More InfoThe ICD-10-CM Tabular List of Diseases and Injuries 2018 Addenda provides insight to future diagnosis coding. Let’s review what is new, deleted, and revised in chapters 1-7. In future months, we will cover additional chapters. Chapter 1: Certain...
More InfoWhen your reimbursement staff is working old accounts receivable while also trying to stay up-to-date with current billing and collection activity, they can quickly feel overwhelmed. While the high dollar claims always need to remain a priority...
More InfoThe multiple procedure payment reduction (MPPR) means that if a healthcare provider performs multiple procedures during a single patient encounter, Medicare (and many commercial insurers) typically will pay “full price” for only the...
More InfoThe one thing doctors should be doing is making sure their patients have their address correct with Medicare. The patient won’t get a new card if their address is not correct. This simple reminder could diminish ongoing problems for...
More InfoGet a jump on five new HCPCS Level II codes going into effect July 1,2018. All are Q codes and they help patients with opioid addiction, knee pain, cystic fibrosis, and hemophilia. Q9991 Injection, buprenorphine extended-release...
More InfoThere is nothing more frustrating to physicians than knowing a patient needs a certain diagnostic test or medication and having them not be able to get it because their health insurance company won’t cover it. All too often, many services require...
More InfoBlue Cross Blue Shield of Michigan is piloting a bundled payment program with 64 surgeons at seven health systems in the state. Here are the four highlights. BCBSM aims to shave 10 percent off the average cost of non-complicated knee or joint...
More InfoLearn the right way to code ‘incomplete’ colonoscopies Billing Medicare and other payers for endoscopy services is pretty different from billing for other types of procedures. And if you’re like most coders/billers, you’re probably making some...
More InfoMedical coders play a crucial role in the revenue cycle process, as they help ensure health systems, hospitals and physicians are properly reimbursed for the services they provide. Here are 14 things to know about medical coding. AAPC describes...
More InfoKey: Amount of time spent with the patient indicates which code to use. Coding for physician inpatient services, especially critical care, is deceptively straightforward. The reality is that the details of each code requirement can complicate...
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