Category: Blog

Outpatient Billing

Eight Things You Should Do Now To Clean Up Your Outpatient Billing

Tips for improving outpatient billing, coding and CDI. In moving from inpatient clinical documentation improvement (CDI) to outpatient CDI, I have been discovering some unique educational pointers. I know we are all very busy, so let’s just dive right into it. Doctors and coders, you should not have diagnoses that are mutually exclusive to one […]
Learn More
Medicare-reimbursement

CMS Finalizes 2020 Medicare Reimbursement Rates for Kidney Care

The final rule for the CY 2020 End-Stage Renal Disease (ESRD) Prospective Payment System will boost Medicare reimbursement to encourage dialysis innovation. CMS last Thursday finalized a rule that will bump the bundled Medicare reimbursement rate for end-stage renal disease (ESRD) providers by $4.06 in 2020 and create a transitional add-on payment adjustment for certain new dialysis […]
Learn More
HCPCS Level II code changes

HCPCS Level II Code Changes for 2020

Centers for Medicare & Medicaid Services (CMS) unveiled the HCPCS Level II code modifications for 2020 on November 8th. These alterations encompass an extensive array of fresh, revised, and eradicated codes, serving as the means to document Medicare Part B services. The 2020 HCPCS Level II edition is set to incorporate a total of 191 […]
Learn More
clinical document improvement

Providers Ready for AI Clinical Documentation Improvement Tools

88% of providers are eager to implement clinical document improvement technology that leverages AI, and 93% believe the systems can streamline document creation. Forty-four percent of healthcare organizations already use artificial intelligence (AI) in one form or another, and more hospitals are looking to apply the technology to coding and clinical documentation improvement, a recent […]
Learn More
Surgery Modifiers

Check NCDs for ICD-10-CM Diagnosis Code Updates

Changes to ICD-10-CM Diagnosis Code mean NCD coding changes. ICD-10-CM Diagnosis Code changes went into effect Oct. 1, as usual, and the Centers for Medicare & Medicaid Services (CMS) is updating National Coverage Determinations (NCDs) to reflect those changes. NCDs Affected by Updates to ICD-10-CM Diagnosis Code CMS notes the following NCD coding changes in […]
Learn More
Patient Billing Disputes

How Hospitals Avoid or Reduce Patient Billing Disputes

CMS’ reworked the Merit-based Incentive Payment System, to simplify reporting requirements for providers in its 2020 Physician Fee Schedule Quality Payment Program Final Rule.Patient billing disputes result in more work for hospital staff and can potentially stand in the way of timely payment for services. However, many organizations are making efforts to avoid or reduce […]
Learn More
EM Code

Final Physician Payment Rule Keeps E/M Code Changes

CMS on Friday issued its 2020 final rules for the Physician Fee Schedule, including a streamlining of evaluation and management services (E/M) reporting that was rolled back from an earlier proposal in a change providers applauded. The final rule, which is mostly unchanged from the proposed rule put forward in July, also cuts payments to physical therapists […]
Learn More
ICD-11 Coding

The Train Has Left the Station: ICD-11 on its Way

New series to focus on preparing for the new code set. ICD10monitor and Talk Ten Tuesdays are launching a new series today, which will continue through November, focusing on the need for early preparation for the new ICD-11 code set that most expect will be ready for the U.S. implementation in 2022. “Now, five years after ICD-10 […]
Learn More
Code for Remote Patient Monitoring

Medicare Remote Patient Monitoring: CMS Finalizes New Code and General Supervision

CMS just released the 2020 final rule with changes to remote patient monitoring (RPM), officially titled “Chronic Care Remote Physiologic Monitoring,” reimbursed under the Medicare program, as part of the Physician Fee Schedule changes. The changes, proposed earlier this year, have been hotly-anticipated by digital health companies hoping to see more clarity and flexibility for RPM services. CMS […]
Learn More
x