Category: Blog

OB/GYN Coding

Correct Common OB/GYN Coding Mistakes

Overlooking separately billable services rendered during the global period will cost your practice dearly. Many obstetrics/gynecology (OB/GYN Coding) practices are coding deliveries incorrectly or failing to submit claims for “problem visits” during a prenatal or postpartum visit. Common mistakes such as these not only fail to capture payment for services rendered but also the meaningful […]
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Emergency Claim Denials

How to Approach Emergency Department Claim Denials

By now, many hospitals have received denials for emergency department level-of-care coding. We could legitimately ask, “how did this happen?” Today we shall address how it started, why it’s important, and potential institutional responses. Denials for emergency care are not new. The spectrum of denials and the audacity with which payers deny claims now strains […]
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Allzone MACRA MIPS

Thinking Strategically About MACRA and MIPS: Will it Be Sink or Swim in 2019?

In Part One of this two-part article exploring the implications of MACRA for healthcare providers, healthcare leaders and health IT experts discuss why it’s critical for clinicians to think strategically, rather than tactically, about MACRA compliance. Numerous industry surveys have highlighted that U.S. physicians, by and large, remain unprepared for managing and executing Medicare Access […]
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Medicare Cards

The New Medicare Cards: What You Need to Know About Medicare Beneficiary Identifiers (MBIs)

To protect the privacy of Medicare recipients and prevent fraudulent use of Social Security Numbers (SSN), a new, unique 11-character Medicare Beneficiary Identifier (MBI) is replacing the SSN-based Health Insurance Claim Number (HICN) for Medicare transactions such as billing, eligibility status, and claim submissions. The MBI does not change Medicare benefits. What’s Behind The Change? The […]
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LT/RT Modifiers

Change To RT And LT Modifiers Use

The Durable Medical Equipment Medicare Administrative Contractors (DME MAC) are changing the requirement that medical coders to use the right (RT) and left (LT) modifiers for certain HCPCS codes, and that the modifiers be used when billing two of the same item or accessory on the same date of service and the items are being used bilaterally. The […]
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ICD-10-PCS Code

CMS Releases FY 2020 ICD-10-PCS Codes Set

CMS released the fiscal year (FY) 2020 ICD-10-PCS changes on Friday, May 31, which include two code revisions, 734 additions, and 2,056 invalidations. The files include information on ICD-10-PCS updates that all inpatient coders must use for discharges occurring from October 1, 2019, through September 30, 2020. The total number of ICD-10-PCS codes for 2019 was 78,881. […]
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