Month: January 2020

Artificial Intelligence The Benefits to Revenue Cycle Management

Artificial Intelligence: The Benefits to Revenue Cycle Management

Artificial intelligence (AI) is a concept that has moved very quickly from the realm of science fiction into real and practical utility in a number of different industries—including healthcare. One of the most effective applications for AI-powered tools is in the field of revenue cycle management. Sophisticated AI technologies can sift through vast amounts of […]
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New Patient EM Denials

New Patient E/M Denials: Mystery Solved

New patient evaluation and management (E/M) claims are being denied when the patient was previously seen by a specialty physician assistant or specialty nurse practitioner on staff. This is happening when another provider of a different specialty in the same multi-specialty group sees the patient for the first time and bills a new patient E/M […]
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Strategies to Mitigate Shrinking Reimbursement in Emergency Medicine

Strategies to Mitigate Shrinking Reimbursement in Emergency Medicine

Emergency departments are under intense pressure to do more with less, and drilling down into clinical and operational data can provide opportunities to offset decreasing revenues Many emergency providers are starting to find themselves caught within a perfect storm, with pressure from reduced reimbursements building steadily across all payer types. Medicare payments for emergency care have effectively […]
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ICD Coding and Climate-Related Psychiatry

ICD Coding and Climate-Related Psychiatry

Anyone who has viewed the wildfires in Australia knows why it has been called the “canary in the coal mine” of climate change. No wonder that Solastalgia was discovered there. As the ever-increasing carbon is being emitted from the world’s coal mines and other fossil fuel sources, life as we know it is at increased […]
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10 Tips To Prepare Practices For E/M Office Visit Codes Changes

The Centers for Medicare and Medicaid Services has taken steps to overhaul codes used for Evaluation and Management (EM) office visit codes. The initiative aims to reduce documentation burdens that interfere with patient care, the American Medical Association says. The professional organization for the nation’s physicians is providing a series of educational materials to support […]
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Non-Physician Provider Use of E&M Codes

Non-Physician Provider Use of E&M Codes

Q: There seems to be a trend of practices using a variety of staff as ‘educators’ to provide patient education. The more recent ‘twist’ is the billing of E&M codes for non-physician providers, based in either clinical documentation or time-based, under the ‘incident to” provision – even though the physician does not see the patient for these […]
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Medical Coding With AI

The Future Of Work Now – Medical Coding With AI

The coding of medical diagnosis and treatment has always been a challenging issue. Translating a patient’s complex symptoms, and a clinician’s efforts to address them, into a clear and unambiguous classification code was difficult even in simpler times. Now, however, hospitals and health insurance companies want very detailed information on what was wrong with a […]
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4 Steps for Improved Excision Coding

4 Steps for Improved Excision Coding

Consideration of several factors, such as the type of removal, lesion size and location, pathologic results, intent, etc., is key to accurately coding dermatological lesion removal procedures. Let’s review the codes and guidelines for lesion removal by excision and how to avoid common mistakes when coding these skin procedures. Excision – Benign/Malignant Lesions (11400-11646) Excision […]
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