Q: Do the new 2021 coding rules for office visits apply to all payers or just Medicare and Medicaid? Also, are these rules just for office visits, or can we use them for hospital visits, nursing home services, and home visits? A: The changes to the documentation requirements are for codes 99202-99215 only and are […]
The Covid-19 pandemic is transforming how physicians practice medicine and bill for it. Physicians who take a consumer-oriented approach to their billing cycle may adapt the best, says John Behn III, MPA, president of Stroudwater Revenue Cycle Solutions and a principal of Stroudwater Associates, a national healthcare consulting firm based in Portland, Maine. “We’ve seen […]
Practices have been creative during COVID-19 to ensure safe patient access: Telephone visits. Curbside immunizations. Drive-up virus testing. Even checking patients in for their in-office visits while they wait in the car. However, each of these scenarios poses one significant challenge: Collecting copayments and coinsurance. “With COVID-19, you’ve got to find ways to meaningfully engage […]
Clinicians who served more patients with social risk factors such as low income performed worse in the Merit-Based Incentive Payment System’s inaugural payment year, and therefore, received unfavorable value-based reimbursement, according to a new study. The study recently published in Health Affairs found that out of 510,020 clinicians participating in the Merit-Based Incentive Payment System (MIPS) in […]
The World Health Organization (WHO) updates ICD codes every 10 years to improve clinical use and acknowledge innovations in healthcare. After the tumultuous transition to the 10th revision of the International Classification of Diseases, simply mentioning the phrase “ICD-11” is liable to strike fear in the hearts of revenue cycle professionals and healthcare providers across […]
One of the codes, CPT Code 99072, is for reporting additional supplies used to mitigate spread of the virus. The American Medical Association (AMA) announced, Sept. 8, two new Category I CPT® codes to meet the changing needs of the healthcare industry brought about by the COVID-19 public health emergency (PHE). The codes were approved […]
Make sure your diagnosis coding is up to date by reviewing this chapter-by-chapter summary of the changes effective October 1. The future is here, and it brought diagnosis codes for hoverboard accidents. But that’s not all that’s changed in ICD-10-CM 2021, effective Oct. 1, 2020, through Sept. 30, 2021. Below are highlights from the 56-page […]
The American Medical Association (AMA) implemented major changes to the 2021 Current Procedural Terminology (CPT) code set in an effort to simplify coding and documentation of office visits and other outpatient evaluation and management (E/M) services. The code set released earlier today modified E/M office visit codes 99201 through 99215 to eliminate history and physical exam as […]
In the upcoming year, medical coders can anticipate a more streamlined process in adapting to the revised code set, which encompasses alterations in E/M codes and more. Notably, the CPT® Editorial Panel has sanctioned a smaller number of new codes for 2021, providing a welcomed respite. This is particularly relieving in light of the comprehensive […]
As RPA’s value for revenue cycle continues to be explored, leaders need to go beyond the hype and determine a practical path to innovation that takes into account the organization’s capacity for innovation and the road map that will best take the organization to its desired digital destination. A recent survey shows 15% of healthcare revenue cycle […]










