Category: Medical Coding

Adapting Risk Adjustment Coding

How Adapting Risk Adjustment Coding Can Change Healthcare Landscape?

Risk adjustment coding plays a vital role in the healthcare sector by capturing and documenting the severity of patient conditions. Its primary purpose is to guarantee precise reimbursement and risk adjustment scores. Given the ever-changing healthcare landscape, it is imperative for healthcare providers and coding professionals to remain adaptable and well-informed about the evolving requirements. […]
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Medical Coder's Challenges

The Top Challenges Faced by Medical Coders Today

Medical coding is a crucial aspect of the healthcare industry. It involves the transformation of medical diagnoses, procedures, and services into universal codes that can be easily understood and processed by healthcare providers and insurance companies. Despite its importance, medical coding is not without its challenges. Here are some of the top challenges faced by medical coders […]
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EM Coding Guidelines

Comparing 2023 CPT® E/M with Documentation Guidelines

The 1995 and 1997 Documentation Guidelines and the 2023 CPT® E/M Services Guidelines are not drastically different when compared side by side. Some hospitals and coding and billing entities may believe that the new 2023 CPT® evaluation and management (E/M) services guidelines and code changes simplify the coding, billing, and auditing processes. However, it is […]
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Coding Requirement Reduced EHR Burden

New Coding Requirements Result in Reduced EHR Documentation Time for Doctors

According to a research letter published in top journal, the attempt by Centers for Medicare & Medicaid Services (CMS) to alleviate the EHR documentation burden on physicians has not yielded the anticipated outcomes. At the beginning of 2021, Centers for Medicare & Medicaid Services (CMS) revised the evaluation and management (E/M) coding requirements for outpatient […]
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Benefits of Automated Medical Coding

How Automated Medical Coding Benefits Healthcare Sectors?

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, […]
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Updated HCPCS Coding Guidelines

Guide to the Latest HCPCS Level II Codes

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 […]
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Top 4 Compliance Policies and Procedures for All Healthcare Entities

Top 4 Compliance Policies and Procedures You Need to Know

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 […]
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Rules for Coding Emergency Department

CMS Rules for Coding Emergency Department Claims | Best Practices

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 […]
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