Category: Medical Coding

Top 4 Compliance Policies and Procedures You Need to Know

Top 4 Compliance Policies and Procedures You Need to Know

Your healthcare entity is at risk if these elements aren’t part of its compliance plan. As healthcare workers, it’s our responsibility to know and understand that the Office of Inspector General (OIG) expects all healthcare entities to follow and abide by its self-proclaimed seven elements of an effective compliance program. The first element, implementing written […]
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CMS Rules for Coding Emergency Department Claims | Best Practices

CMS Rules for Coding Emergency Department Claims | Best Practices

The Centers for Medicare and Medicaid Services (CMS) has consistently authorized hospitals to establish and utilize their own coding guidelines for emergency department facility claims. CMS makes clear that “[a]s long as the services furnished are documented and medically necessary and the facility is following its own system, which reasonably relates the intensity of hospital […]
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Mastering Medical Coding: Strategies To Avoid Revenue Loss

Mastering Medical Coding: Strategies To Avoid Revenue Loss

Medical coding is an essential aspect of healthcare in that it translates diagnoses, procedures, medical services, and equipment into alphanumeric codes. The processes involved in medical coding is complex, however, so errors can often result in payment delays and significant financial losses. The most common errors leading to delays and lost revenue are tracking down […]
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Using Modifier – 25 on an E_M Visit

Using Modifier – 25 on an E/M Visit

In recent years, there has been an increase in scrutiny regarding the use of modifier -25 to identify separate evaluation and management (E/M) services on the same day as another procedure. Insurers are now demanding documentation of such services both before and after payment, leading to a significant administrative burden for urology practices. The reason […]
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