Guidance for using out-of-office BPs is not new. Medical evidence and clinical guidelines published over the last decade have showcased the importance of 24-hour ambulatory monitoring as the reference standard, and self-measured blood pressure monitoring (SMBP) as an acceptable alternative for obtaining BPs to diagnose and treat hypertension. And thanks to that abundance of research […]
The implementation of artificial intelligence into healthcare is becoming more widespread by the day. EHRs may have worked to improve data use among medical providers, but these tools are still far from perfect. Digital medical records have introduced a host of problems, including disrupting clinician workflows, limited interoperability, and creating data overload. But with the […]
Several CMS-designated permanent and product-specific J-codes recently went into effect, allowing three ophthalmology-minded pharmaceutical companies to expand reimbursement through commercial and Medicare insurance plans. J-codes were activated Oct. 1 for FDA-approved products manufactured by EyePoint Pharmaceuticals, Ocular Therapeutix and Omeros. In the past, J-codes were announced once a year; now, CMS is issuing certain J-codes […]
Among the upcoming changes to the CPT code set are updates to the radiology codes and medicine sections. This article discusses those updates, which take effect for all claims submitted on or after Jan 1. New CPT code Revised CPT code Resequenced CPT code Designated add-on CPT code Radiology Many “radiologic exam” radiology codes were […]
Sound accounts receivable (A/R) management is integral to the financial health of a medical practice. The ability to maximize collections and profitability depends on it. Thus, it’s important that practices know what processes they can implement to ensure a smooth-running AR operation. David Norris, MD, MBA, an anesthesiologist in Wichita, Kan. and author of The […]
First hand experiences from the country’s most innovative revenue cycles will be shared next month in West Palm Beach, Florida. What issues keep revenue cycle executives up at night? As the HealthLeaders’ revenue cycle editor, I will moderate discussions and hear firsthand experiences of successes, challenges, and the latest ideas coming out of the country’s most innovative […]
E&M codes are the most frequently used codes in any physician practice. Change is coming to the world of evaluation and management (E&M) services. With the Physician Fee Schedule Final Rule for 2020 now published, we know there are big changes to be expected in 2021. The good news is that there’s a year to […]
HCCs thrive on specificity and ICD-11 will provide a higher level of specificity than in ICD-10. For those of you who are HCC coding for hierarchical condition category (HCC) purposes, you know that HCCs are categories of related ICD-10 codes. Only selected significant conditions to drive a payment HCC coding. That means only conditions that […]
You are indeed correct that ICD-10 coding makes its updates on Oct. 1 for the following year. This means the codes actually update on that date and any date of service on or after Oct. 1 must use the new or updated code to be valid. CPT codes or procedure codes actually do not update […]
In August, the Centers for Medicare & Medicaid Services (CMS) announced proposed modifications to the Merit-Based Incentive Payment System (MIPS). As physician practices work to understand what’s changed, there are certain aspects of which they need to be aware. The following sections provide key takeaways and offer strategies for meeting the coming year’s requirements. Threshold […]