Category: Medical Coding

Medical-Necessity-Denials-Image

How to avoid medical necessity denials

How to avoid medical necessity denials and ensure timely payment. Sick visit on the same day as an annual wellness visit (AWV) Reason for denial: Lack of clear clinical documentation regarding why the physician had to go above and beyond what is normally addressed during an AWV. How to avoid it:“I often tell doctors to […]
Learn More
what-ai-can-and-cant-yet-do-in-payment-integrity

What AI Can and Can’t Yet Do in Payment Integrity

It’s important to be realistic about what AI can and can’t do currently. Artificial intelligence (AI) has been a buzzword in payment integrity for years. Companies are increasingly using AI and data mining to identify healthcare savings. This technology can be helpful in the right scenarios. Data versus Nuance AI, which includes technologies like machine […]
Learn More
2022-care-management-services-codes-to-know

2022 care management services codes to know

Question: Can you please tell us what the new codes are for principal care management and chronic care management? Answer: There are three new codes in the care management section of the CPT codebook. Care Management Services Principal Care Management Services New CPT codes have been added in 2022 to describe “Principal Care Management Services.” […]
Learn More
the-past-present-and-future-of-em-services

The Past, Present, and Future of E&M Services

Providers are currently stuck with outdated templates, leaving plenty of room for improvement. I thought it might be appropriate to take a “four score and seven years ago” look across evaluation and management (E&M) services, looking at what we had, what we have, and what is still to come. So, to begin, I will rewind […]
Learn More
Hundreds of new inpatient procedure codes finalized for fy 2023

Hundreds of new inpatient procedure codes finalized for fy 2023

CMS finalized the fiscal year (FY) 2023 inpatient procedure code set along with accompanying guidelines. KEY TAKEAWAYS331 new procedure codes will become effective October 1.The middle revenue cycle will need to be updated on recent coding changes that will affect hospital reimbursement. The FY 2023 ICD-10-PCS procedure code set and the ICD-10-PCS Official Guidelines for […]
Learn More
new-procedure-codes-coming-this-fall

New Procedure Codes Coming This Fall

Look for them at a hospital near you. The ICD-10-PCS update for fiscal year 2023 is now available. To prevent coding errors that result in claim denials, inpatient coders should download the code files and familiarize themselves with the changes to inpatient coding that go into effect Oct. 1. The fiscal year (FY) 2023 ICD-10-PCS […]
Learn More
regulations-open-doors-for-telehealth-services-in-fqhcs

Regulations Open Doors for Telehealth Services in FQHCs

Make sure your facility is aware of all the Medicare policy changes that permit payment for expanded services. Telehealth as a healthcare delivery platform has been in existence since the late 1960s. It was first introduced through projects initiated by the National Aeronautics and Space Administration (NASA) and the Nebraska Psychology Institute. The declaration of […]
Learn More
x