Category: Blog

Revenue Cycle Initiatives

4 Revenue Cycle Initiatives Fast-Tracked by COVID-19

  Projects on the backburner, like having a remote workforce, paperless patient communications, and electronic signatures, have been implemented faster out of necessity. For years, revenue cycle executives have talked about modernization wants and needs. But in many healthcare organizations, a lack of time, money, or will—or all three—have stood in the way of moving […]
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CMS IPPS Rule

2021 IPPS Proposed Rule: CMS Proposes Increased Payment Rates

According to the proposed rule, CMS projects total Medicare spending on inpatient hospital services, including capital, will increase by about $2.07 billion in FY 2021. CMS’ fiscal year (FY) 2021 Inpatient Prospective Payment System (IPPS) proposed rule, released May 11, includes a proposed increase to hospital payment rates, the creation of a new Medicare-Severity Diagnosis-Related Group […]
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Medicare Telehealth Coding

Medicare Telehealth Coding as of April 30

Healthcare providers are granted even more latitude for use of telehealth services during the COVID-19 public health emergency. On a Friday, at month-end, the Centers for Medicare & Medicaid Services (CMS) kindly dropped another bomb on us: more temporary policy changes during the public health emergency for COVID-19. We may have this all sorted out just […]
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Telehealth Medical Billing

Medical Billing for Telehealth During COVID-19

COVID-19 is changing the way we practice medicine. Social distancing measures have led to a surge in demand for telemedicine, while practices around the country are seeing a reduced number of in-office patient visits. While the regulatory environment has not always been favorable towards telehealth, federal and state legislations have recently loosened in an effort […]
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COVID-19 Coding

Coding in Age of COVID-19: Deciphering Coding Nuances, Best Practices

  Without much warning, the novel Coronavirus, or COVID-19, has taken over our healthcare system. It has taxed our healthcare workers, our national stockpiles of PPE, and affected millions of Americans nationwide. In addition to healthcare workers on the front lines, the pandemic has also impacted the healthcare revenue cycle, causing major confusion, questions, and inconsistencies as […]
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Radiology & Imaging CPT Codes

2020 Radiology and Imaging CPT Change

  Become a coding superhero with X-ray vision. When is imaging separately reported, and how? The relative value units (RVUs) for some codes include the provider’s use of imaging to accurately visualize the specimen or problem the code is meant to address. The most notable changes with regards to radiology for 2020 can be found […]
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COVID-19 Antibody Testing

Coronavirus: FDA Updates Antibody Testing Guidance

  The U.S. Food and Drug Administration (FDA) has updated COVID-19 antibody testing guidance. According to a news release, the revised rule allows laboratories and commercial manufacturers to help accelerate the use of tests they develop to expand rapid testing capacity. The rule allows companies to develop and distribute serological, antibody, tests after validation while an […]
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Telemedicine Billing

New Billing Basics for Telemedicine

Betsy Nicoletti, MS, a nationally recognized coding expert, will take your coding questions via email and provide guidance on how to code properly to maximize reimbursement. Have a question about coding? Send it here. In this column, Nicoletti outlines some key guidance for using telemedicine. These rules would apply during the Centers for Medicare & Medicaid […]
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COVID-19 Diagnosis

Diagnosing COVID-19

Clinical judgment is sufficient for COVID-19 diagnosis. When I was a third-year resident, in 1987, I saw a really sick kid in the ED. He was about 5 years old, had a fever of 104°, and was lethargic in his mother’s arms. His eyes were swollen and infected, and he had a runny nose and […]
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