Primary care physicians (PCPs) face increasing challenges in the current healthcare environment: not having enough resources to care for patients, declining practice revenues, and overwhelming administrative burdens. On top of all that, there is a necessary, but mounting pressure to shift to value-based care. Having run a cardiothoracic surgery practice for 25 years, I have […]
Leveraging technology, auditing for compliance, and providing robust education are key ways providers can improve medical coding quality. While some have said medical coding sits quietly in the middle of the healthcare revenue cycle, it is a key step that, when done inadequately, can impact each part of the revenue cycle after it. Medical coding quality is […]
Physicians can now offer more services via telehealth and get paid. The Centers for Medicare & Medicaid Services (CMS) is adding 11 codes to the list of telehealth services payable under the Medicare Physician Fee Schedule (MPFS). Coverage is retroactive to March 1, 2020, and is effective for the duration of the public health emergency (PHE) for […]
Becker’s ASC Review compiled a timeline of significant medical coding updates that have been proposed or implemented so far this year: January CMS began paying for certain angioplasty and stenting procedures in ASCs on Jan. 1, under its 2020 Medicare Hospital Outpatient Prospective Payment System and ASC Payment System Final Rule. Here are the Current Procedural Terminology […]
Usability and interoperability are top physician complaints, but will 2021 bring any relief? Physicians often see the EHR as the bane of their professional existence, complaining about awful user interfaces and a lack of interoperability with other systems that forces them to access multiple platforms to get the information they need on one patient. But […]
The American Medical Association (AMA) says the proposed Medicare 2021 fee schedule should be modified to reflect changes brought on by the ongoing COVID-19 coronavirus pandemic. In detailed comments submitted to Centers for Medicare & Medicaid Services (CMS) Administrator Seema Verma, the AMA warned that some proposed regulations in the fee schedule would hurt many practices already […]
Good news for physicians tired of counting bullet points to assign an evaluation and management (E/M) level for an outpatient office visit: Per new AMA guidelines, it’s going to be a whole lot simpler. As of January 1, 2021, physicians will select an E/M code based on total time spent on the date of […]
Facility-specific coding guidelines are key to code hospital visits and encounters consistently. Another role that facility-specific guidelines play is to capture all possible reimbursement that is due to an organization. Every Oct. 1, the MS-DRGs and ICD-10-CM/PCS are updated. In addition to the MS-DRGs, the New Technology Add-On Payments (NTAPs) are updated as well. It […]
The American Medical Association (AMA) today published an update to the Current Procedural Terminology (CPT®) code set that includes new code additions and editorial revisions for reporting medical services sparked by the public health response to the COVID-19 pandemic. The update to the CPT code set was approved by the CPT Editorial Panel, the independent body convened […]
The American Medical Association updated its Current Procedural Terminology set to include updates to coding for tests that detect influenza and COVID-19. The two new codes, per the AMA’s CPT editorial panel, are: 87636: “Infectious agent detection by nucleic acid (DNA or RNA); severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) (Coronavirus disease [COVID-19]) and influenza virus types A […]