In November 2019, CMS published the 2020 Quality Payment Program Final Rule (the “2020 MIPS Final Rule Changes”). Below is a summary of some of the most notable changes to the Merit-Based Incentive Payment Program (MIPS). For a complete list of...
More InfoED professional codes are typically assigned by professional coders with specialized training in emergency medicine coding. The CPT® code set, including ED code descriptors and applicable rules, guide this choice based on the documented history...
More InfoPhysicians will potentially have a lighter documentation burden and more time to spend with patients in 2021 thanks to an overhaul of Medicare Coding guidelines for outpatient evaluation and management (E/M) services. “The whole point was to have...
More InfoAs the U.S. responds to a growing threat of the 2019 novel coronavirus, CMS and other organizations are clarifying how to code for testing and treatment of the disease. Six things to know: 1. CMS created a new Healthcare Common Procedure Coding...
More InfoPrior authorizations, or prior approvals, are strategies that payers use to control costs and ensure their members only receive medically necessary care. The cost-control process requires providers to acquire advance approval from payers before...
More InfoImproving data analytics in healthcare has potential includes cost savings and improved patient health and wellness. Here are the two ways through which this improvement can be accomplished: Adopt a business analytics strategy that process huge...
More InfoMuch of the buzz you hear about artificial intelligence (AI) or machine learning (ML) in healthcare is about its clinical applications, whether assisting doctors with diagnoses or customizing cancer treatment plans. But healthcare is a big...
More InfoCoronavirus continues to dominate the news. This is a developing story will continue to update you on the latest development on this global health crisis. In the wake of the deadly coronavirus (nCoV), U.S. hospitals are preparing for an emergency...
More InfoMACs may be applying the multiple endoscopy rules incorrectly. In the 2020 Medicare Physician Fee Schedule (MPFS) Final Rule, the Centers for Medicare & Medicaid Services (CMS) finalized the proposal to apply the special rule for multiple...
More InfoPresident Trump’s proposed FY 2021 budget includes hospital reimbursement cuts, including more site-neutral payments, as well as a unified post-acute care payment system. President Trump’s proposed budget for the 2021 fiscal year (FY) is stirring...
More InfoFebruary is the month of love, where every valentine will wait to celebrate and every single will wait to became a couple. In this day will anybody think about the medical billing and medical coding, absolutely not? However you need to be...
More InfoDive Brief: In the first two years diagnostic codes specific to social determinants of health were available in Medicare fee-for-service claims, they were used for only 1.4% of the total beneficiary population, according to a new report from CMS...
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