Effective from discharges/visits on October 1, 2022, the 2023 Official Coding and Reporting Guidelines for ICD-10-CM have been established. On July 7, 2022, the Centers for Medicare and Medicaid Services (CMS) issued MLN Connects, featuring an article focusing on long COVID. This article imparts guidance on coding practices for both long COVID and ongoing COVID […]
Open communication, payment options, and understanding are all key to improving patient collections in a consumer-oriented healthcare landscape. The rising cost of healthcare in the United States has left consumers feeling lost and overwhelmed. High deductible healthcare plans, co-pays, and out-of-pocket medical expenses have all contributed the emergence of healthcare consumerism, which is the pursuit […]
The reverberations of the 2021 evaluation and management (E/M) documentation guidelines have barely subsided, yet we are already on the verge of witnessing further changes in this segment of CPT® for 2023 – and this time, the implications stretch beyond mere office visits. If your healthcare institution conscientiously adopted the 2021 E/M guidelines, there’s no […]
Twenty percent of adults said they or a family member has received a surprise medical bill since the No Surprises Act went into effect on Jan. 1 according to a Morning Consultant report released July 7. Morning Consultant conducted a survey among a representative sample of 2,210 U.S. adults between June 22-24, according to the […]
Nearly half of CFOs and revenue cycle VPs in a recent survey said their organizations are behind their 2022 healthcare revenue goals. Most provider organizations are behind their 2022 healthcare revenue goals, according to a recent survey of health system and physician group finance leaders. Revenue cycle management technology vendor R1 RCM commission Census wide, […]
The American Medical Association (AMA) has created three new CPT® codes to report the administration of the Moderna COVID-19 vaccine for patients 6 through 11 years. The new codes are effective June 17, 2022. Note These New Moderna Admin Codes For children ages 6 through 11 years, report the Moderna vaccine with existing CPT® code […]
A new analysis shows that claim denial rates for in-network services among Healthcare.gov marketplace payers varied significantly, with some as high as 80%. Claim denial rates varied significantly among Healthcare.gov marketplace payers, with some insurers racking up rates as high as 80 percent, according to a new analysis from Kaiser Family Foundation. Marketplace payers must […]
The effective date for 0081A-0083A and 91308 is June 17, 2022. The Food and Drug Administration (FDA) granted emergency use authorization (EUA) to the Pfizer-BioNTech COVID-19 vaccine for patients ages 6 months to 4 years. The new CPT® codes for reporting this vaccine are: 0081A Immunization administration by intramuscular injection of severe acute respiratory syndrome […]
Medicare updates its policy for these services to align with CPT®. The Centers for Medicare & Medicaid Services (CMS) revised its Part B benefit policy for critical care services, effective Jan. 1, 2022. Policy changes finalized in the 2022 Medicare Physician Fee Schedule (MPFS) final rule include a new definition of critical care services, who […]
Implement a compliance process in your practice for querying providers for outpatient services. Querying providers about their documentation may seem inappropriate, but it is an important part of the medical coding process. A physician query allows a medical coder to formally ask a healthcare provider a question about something they wrote (or didn’t write) in […]