The relationship between medical coding and patient care may not initially appear connected, and they may even seem like complete opposites. While medical coding focuses on billing and revenue, patient care revolves around providing care to individuals. An from leading E-magazine’s recent article emphasized this distinction, asserting that prioritizing care is essential over coding. However, […]
A retroactive effective date of April 1 has been assigned to a newly introduced code. The Centers for Medicare & Medicaid Services (CMS) has released the results of its review cycle for drug and biological HCPCS Level II codes in the first quarter of 2023. Out of the 36 applications received, 23 have been approved […]
Your healthcare entity is at risk if these elements aren’t part of its compliance plan. As healthcare workers, it’s our responsibility to know and understand that the Office of Inspector General (OIG) expects all healthcare entities to follow and abide by its self-proclaimed seven elements of an effective compliance program. The first element, implementing written […]
The Centers for Medicare and Medicaid Services (CMS) has consistently authorized hospitals to establish and utilize their own coding guidelines for emergency department facility claims. CMS makes clear that “[a]s long as the services furnished are documented and medically necessary and the facility is following its own system, which reasonably relates the intensity of hospital […]
Having been on the receiving end of audits, and also having been an individual who has conducted them, I know the mindset from both sides of this equation. The one element to this equation that has changed over time is the increase in payer denials: those that are now clinical- and coding-focused, often resulting in […]
CHICAGO – Much of remote digital health depends on the Current Procedural Terminology, or the CPT code set, which opened the door to payment for remote patient monitoring and remote therapeutic monitoring. Providers should be aware of CPT changes, especially for any codes that may be going away at the end of the public health […]
Medical coding is an essential aspect of healthcare in that it translates diagnoses, procedures, medical services, and equipment into alphanumeric codes. The processes involved in medical coding is complex, however, so errors can often result in payment delays and significant financial losses. The most common errors leading to delays and lost revenue are tracking down […]
The new code set has been officially adopted by 35 countries. The World Health Organization (WHO) officially unveiled the first version of ICD-11 in February 2022, marking the eleventh version of the International Classification of Disease (ICD) as officially implemented. Recently, in February 2023, the WHO announced the release of ICD-11 2023 version, just a […]
The agency proposes to strengthen the ties that bind payments to quality data reporting. The Centers for Medicare & Medicaid Services (CMS) issued, April 10, the Inpatient Prospective Payment System/Long-Term Care Hospital (IPPS/LTCH) proposed rule for fiscal year (FY) 2024. If finalized as written, inpatient hospitals and LTCHs that do not successfully report quality data […]
You won’t find these codes in your 2023 code books, but they are effective April 1. The Centers for Medicare & Medicaid Services (CMS) has released coding changes and policy updates for the Outpatient Prospective Payment System (OPPS). The updates include the addition of many new HCPCS Level II codes, the deletion of a few […]