Category: Blog

Billing Debridement Separately from Surgery

Facts to Avoid Confusion During Debridement Billing

Debridement is a process that involves the removal of foreign material, as well as tissue that is either devitalized or contaminated, until healthy tissue is revealed. Its primary purpose is to clean the affected area and is often performed concurrently with other orthopedic surgical interventions. In my role as an auditor specializing in orthopedics, I […]
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IPPS /LTCH Final Rule – Increasing Operating Payment Rates by 3.1%

Hospitals contend that the 3.1 percent increase in payments linked to quality reporting is insufficient to address the rising inflationary pressures. The Centers for Medicare & Medicaid Services (CMS) has officially published the final rule for the Hospital Inpatient Prospective Payment System (IPPS) and Long-term Care Hospital Prospective Payment System (LTCH PPS) in the Federal […]
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AI-enabled-ICD-10-CM-Guidelines

AI-enabled ICD-10 CM Guidelines: The Future of Medical Coding

In the ever-changing realm of healthcare coding, it is imperative for professionals to stay updated on the latest developments within the International Classification of Diseases, 10th Revision, Clinical Modification (ICD-10-CM). This dynamic coding system plays a pivotal role in recording diagnoses, conditions, and other vital health-related information. With the advent of artificial intelligence (AI) technologies […]
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AI in Healthcare Process

How AI is Transforming Healthcare Operations and Investment

The principal of a healthtech venture capital firm asserts that the most promising AI innovation from an investment standpoint involves rendering business models feasible. Investment focus has now shifted towards AI for a healthtech and medtech venture capital firm, which administers a capital pool exceeding $800 million earmarked for healthcare and technology startups. The healthtech […]
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Medicare-advance-plan

Medicare Advantage Plans: A Positive Experience for Beneficiaries

Higher satisfaction with problem resolution was observed among beneficiaries who were more inclined to renew their Medicare Advantage plan. Medicare Advantage plans have garnered favorable satisfaction scores, with beneficiaries showing high approval ratings for trustworthiness, operational ease, and coverage adequacy, as outlined in a recent market research study. The 2023 US Medicare Advantage Study encompasses […]
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Employer Healthcare Costs to Increase 8.5% in 2024

Employer Healthcare Costs to Increase 8.5% in 2024

A recent study conducted by a leading professional services firm revealed that the anticipated expenses borne by U.S. employers for their workforce’s healthcare will see a notable uptick of 8.5%, surpassing $15,000 per employee. This surge, assuming companies do not introduce augmented employee contribution methods or alternate cost-reducing strategies, stands almost twice as high as […]
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Benefits of Compliance in Medical Billing

How Medical Billing Compliance Can Protect Your Medical Practice?

The process of medical billing encompasses multiple stages, starting with patient registration and eligibility verification, followed by capturing charges, coding, submitting claims, and posting payments. When a patient receives medical services from a healthcare provider, the provider documents the services and associated costs within an electronic health record (EHR) system. Subsequently, a medical billing entity […]
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Upcoming Changes in COVID-19 Vaccine Coding

COVID-19 Vaccine Coding Updates: What You Need to Know

An Oncoming Wave of 70+ Coding Revisions Is Approaching. Starting from November 1st, the American Medical Association is eliminating nearly all of the COVID-19 vaccine-related CPT® codes that were developed over the past several years. Instead, there will be a more concise set of product codes and a solitary administration code to replace them. What […]
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CMS-Proposes-Changes-to-RPM-in-2024-PFS-Proposed-Rule

CMS Proposes Changes to Remote Patient Monitoring in PFS Proposed Rule for 2024

The 2024 physician fee schedule (PFS) proposed rule has been released by the Centers for Medicare & Medicaid Services (CMS). Within this rule, remote physiologic monitoring (RPM), also known as remote patient monitoring, has garnered significant attention. While customary for a proposed rule, CMS has introduced several suggested modifications to RPM. However, what sets this […]
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