The COVID-19 pandemic created a host of challenges for revenue cycle management leaders, from widespread service line shutdowns to shifting staff to work at home and increasing self-pay balances. These pressures have heightened inefficiencies in A/R processes and productivity. While these challenges took a massive financial toll on healthcare organizations—to the tune of $323 billion […]
Q: What CPT codes and modifiers would be used to report excisional debridement for removal of a 2×4-cm ulcer on a patient’s right buttocks with vacuum-assisted closure (VAC)? A: The debridement would be reported using CPT code 11042 (debridement, subcutaneous tissue [includes epidermis and dermis, if performed]; first 20 sq cm or less). This procedure […]
The healthcare sector is in urgent requirement of an AI solution that can process a massive amount of data without compromising the speed and accuracy of billing. Medical billing and coding is a critical component of healthcare. The medical billing outsourcing market alone is estimated to reach $16.9 billion by 2021. The coding and billing […]
Current issue includes most frequently asked questions about coding COVID-19. The American Hospital Association (AHA) central office is the official United States clearinghouse on medical coding for the proper use of the ICD-10-CM/PCS systems and Level I HCPCS (CPT-4 codes) for hospital providers – and certain Level II HCPCS codes for hospitals, physicians, and other health professionals. The […]
Being a physician comes with certain baseline stressors. For most, the culprits are pretty familiar: patient care responsibilities, high debt loads that compel long working hours, system complexities, and mounting administrative chores. COVID-19 has added yet another layer to the burdens that already contribute to physician burnout. As an emergency physician, walking into work every […]
IFHIMA makes the case for ICD-11 adoption with latest whitepaper. As healthcare transformation progresses due to the digitization of data and advancements in medical science and technology, it is increasingly important that nations around the world begin planning for adoption of ICD-11. The International Classification of Diseases (ICD) has a long and valued history of […]
Physicians in a hospital’s emergency department (ED) collected significantly more of the charged amount for likely surprise medical bills compared to other patient cases, a new study in Health Affairs reveals. In the event of a likely surprise medical bill, physicians collected 65 percent of the charged amount compared with just 52 percent for other cases. Researchers also […]
CMS is temporarily holding claims from providers in anticipation of legislation that will extend the suspension of the 2 percent Medicare sequester, according to a recent newsletter. The MLN Connects newsletter from March 30 stated that CMS has “instructed the Medicare Administrative Contractors (MACs) to hold all claims with dates of service on or after April […]
Modifiers 79: Know how to differentiate modifiers 79, 78, and 58to ensure proper reimbursement for all procedures performed. Modifiers convey important information about a claim and can directly affect reimbursement. But choosing the most appropriate modifier can be confusing — especially when two or more modifiers have similar descriptors. Modifiers 58, 78, and 79 are all […]









