Claim denial prevention and management is crucial for a hospital’s financial health. Without an effective approach, organizations may lose or experience delays with reimbursement. A Change Healthcare study found a typical health system could lose as much as 3.3 percent of net patient revenue, an average of $4.9 million per hospital, due to denials. That’s […]
Nearly all healthcare decision makers recently surveyed by KLAS said their organization saw financial gains after implementing a clinical documentation improvement solution. Provider organizations are seeing financial improvements after implementing clinical documentation improvement (CDI) solutions, a recent KLAS survey shows. Revenue improved for about 53 percent of healthcare executives, medical records directors and managers, and […]
There were many code revisions with guidelines, descriptions and instructional note changes. There six new codes in the Evaluation and Management (E&M) section in CPT. Guidelines were revised for Interprofessional Telephone/Internet/Electronic Health Record Consultations. New codes 99451 and 99152 were added to report assessment and management services. The codes are based on medical consultative […]
The big question for many who are new to running and operating an urgent care clinic is how to continue being profitable during a slow flu season in a very competitive market. There are eight key tips urgent care clinics can follow to optimize revenue and remain profitable. 1. Improve RCM: Effective revenue cycle management […]
Medicare claims that do not meet date format requirements will be rejected. The Centers for Medicare & Medicaid Services (CMS) has released date formatting guidelines for the CMS-1500 claim form, which are effective for claims received on or after July 30. When date formatting requirements are not met, Medicare Administrative Contractors will return claims as […]
The CMS’ proposed Medicare Physician Fee Schedule for 2019 includes changes to the quality payment program and a slight increase in the anesthesia conversion factor. Here’s what you need to know: The national conversion factor for anesthesia services will see an increase from $22.1887 to $22.2986. The increase includes the 0.25 percent positive and budget […]
A major shift in the reporting of transgender issues is at hand. They’re here, but it won’t be until sometime until after 2022 that the United States is expected to adopt the codes of ICD-11 – the new International Classification of Diseases, Version 11 – released by the World Health Organization (WHO) in Geneva. According […]
Modifier 74 description: Modifier 74 is used in the medical billing and coding field to indicate that a surgical procedure performed in an outpatient setting was terminated due to extenuating circumstances. When this modifier is applied to a billing code, it signifies that the procedure was initiated but discontinued before completion due to reasons beyond […]
Clinical diagnostic laboratories can look forward to 12 new laboratory codes were effective April 1 and one code effective retroactively January 1. The Centers for Medicare and Medicate Services (CMS) released the changes May 5, 2018. The new codes are contractor priced until addressed at the annual Clinical Laboratory Public Meeting in July. All the […]
After patients have a subcortical stroke in the right hemisphere of their brain, more than one in three experience cognitive decline. That decline may be the result of damage to specific pathways in the brain, according to a new study published in Radiology. “Impairment of attention has been observed in patients with both cortical and […]










