Category: Medical Coding

July 2024 OPPS Update

Comprehensive Overview of CMS July 2024 OPPS Update (CR13632)

The CMS Releases July 2024 OPPS Update (reference: CMS Change Request CR13632, MLN Matters number MM13632). Here’s a summary of key changes: New Coverage for COVID-19 Pre-Exposure Prophylaxis: Drug: PEMGARDA (pemivibart) – Code: Q0224 (Note: This code is not reimbursed under OPPS, but at a “reasonable cost”) Administration: Code: M0224 (Covered: Receives separate payment under […]
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medical coding mistakes

How Medical Coding Mistakes Cost You Money

The administrative burden of accurate medical coding is a major contributor to physician burnout—a challenge exacerbated by the COVID-19 pandemic. Studies consistently rank coding-related stress as one of the top concerns for healthcare providers. Medical Coding Mistakes, whether due to oversight or complexity, can have severe financial repercussions for medical practices. Denied claims, reduced reimbursements, […]
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Benefits of Remote Patient Monitoring (RPM)

The COVID-19 pandemic highlighted the need for alternative healthcare delivery methods. Remote patient monitoring (RPM) emerged as a valuable complement to telehealth, allowing doctors to remotely monitor patients’ health data in real-time. How Remote patient monitoring Works RPM utilizes various devices to track vital signs like blood pressure, heart rate, and blood sugar. It can […]
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CPT® 2024 Update: New Codes and Guidelines

Table of Contents Evaluation and Management Surgery: Musculoskeletal System Surgery: Respiratory System Surgery: Cardiovascular System Surgery: Urinary System Surgery: Female Genital System Surgery: Nervous System Radiology Pathology and Laboratory Medicine Category III Codes 2024 CPT Coding updates:  Take a look at the updates in CPT coding and guidelines for professional services. Every year, on January […]
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Top Strategies to Prevent Medical Billing and Coding Errors

Medical coding and billing errors are a persistent headache for healthcare providers, costing them time, money, and reputation. Studies show that a staggering percentage of medical bills contain errors, leading to denied claims, delayed payments, and frustrated patients. Focus on Prevention: Top coding and billing Errors to Avoid Non-Covered Charges: Verify insurance coverage before rendering […]
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compliant coding and billing

Compliant Coding and Billing for Physicians: Expert Tips

The article explores common billing mistakes and offers tips for four healthcare services that can cause payment headaches for physicians. 1. Annual Wellness Visits vs. Physicals: Understanding Medicare Requirements Differentiating between Annual Wellness Visits (AWV) and Initial Preventive Physical Exams (IPPE) is crucial for accurate billing. Both are covered by Medicare for preventive care, but […]
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chronic migraine with aura

2024 ICD-10-CM Update Enhances Chronic Migraine

The good news for coders is that the 2024 ICD-10-CM update allows for more specific coding of chronic migraine with aura, improving accuracy and potentially helping patients access treatment. Diagnosing Migraine: A Complex Puzzle While the International Headache Society defines chronic migraine, pinpointing the exact type can be challenging. Migraines come in various forms, and […]
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Telehealth coding

Master Telehealth Coding: A Guide to Reimbursement and Avoiding Denials

Navigating the complexities of telehealth coding is crucial for ensuring that services are properly reimbursed. This guide provides essential information and tips for coding telehealth services accurately, helping physicians avoid denials and recoupments. 1. Telephone Services: Use Cases: Suitable for straightforward problems like simple rashes, asymptomatic coughs, and medication refills. Requires a minimum of five […]
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medical-coding-compliance-strategy-to-reimbursement

3 Coding Compliance Strategies to Improve Reimbursement, Quality

The Crucial Role of Medical Coding Compliance in a Value-Based World: Telling the Patient’s Story for Better Billing and Quality Care. Medical Coders: The Unsung Storytellers of Healthcare Medical coders play a critical role in hospitals, but their importance often goes unnoticed. They’re the storytellers behind the scenes, analyzing patient records, selecting billing codes, and […]
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