Category: Medical Coding

Outpatient Billing

Eight Things You Should Do Now To Clean Up Your Outpatient Billing

Tips for improving outpatient billing, coding and CDI. In moving from inpatient clinical documentation improvement (CDI) to outpatient CDI, I have been discovering some unique educational pointers. I know we are all very busy, so let’s just dive right into it. Doctors and coders, you should not have diagnoses that are mutually exclusive to one […]
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Pulmonary Hypertension Coding

4 Tips for Accurate Pulmonary Hypertension Coding

PH WHO groups key to understanding I27 codes. Despite the fact that pulmonary hypertension (PH) is a “frequently identified … highly morbid condition … associated with increased mortality, hospitalizations and financial burden,” it is “rarely coded in the EHR [Electronic Health Record]” according to a recent article published in the Journal of Cardiac Failure. What, then, can you […]
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Medicare-reimbursement

CMS Finalizes 2020 Medicare Reimbursement Rates for Kidney Care

The final rule for the CY 2020 End-Stage Renal Disease (ESRD) Prospective Payment System will boost Medicare reimbursement to encourage dialysis innovation. CMS last Thursday finalized a rule that will bump the bundled Medicare reimbursement rate for end-stage renal disease (ESRD) providers by $4.06 in 2020 and create a transitional add-on payment adjustment for certain new dialysis […]
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HCPCS Level II code changes

HCPCS Level II Code Changes for 2020

Centers for Medicare & Medicaid Services (CMS) unveiled the HCPCS Level II code modifications for 2020 on November 8th. These alterations encompass an extensive array of fresh, revised, and eradicated codes, serving as the means to document Medicare Part B services. The 2020 HCPCS Level II edition is set to incorporate a total of 191 […]
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ICD-11 Coding System

ICD-11: The New Reality for Providers

Now is the time to begin preparing for the new code set. It is good to be back to talk about ICD-11. Yes, it’s a reality now, and all providers can start to get prepared for this significant new ICD-11 coding system. ICD-11 has been years in the making, and it is a result of […]
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clinical document improvement

Providers Ready for AI Clinical Documentation Improvement Tools

88% of providers are eager to implement clinical document improvement technology that leverages AI, and 93% believe the systems can streamline document creation. Forty-four percent of healthcare organizations already use artificial intelligence (AI) in one form or another, and more hospitals are looking to apply the technology to coding and clinical documentation improvement, a recent […]
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Surgery Modifiers

Check NCDs for ICD-10-CM Diagnosis Code Updates

Changes to ICD-10-CM Diagnosis Code mean NCD coding changes. ICD-10-CM Diagnosis Code changes went into effect Oct. 1, as usual, and the Centers for Medicare & Medicaid Services (CMS) is updating National Coverage Determinations (NCDs) to reflect those changes. NCDs Affected by Updates to ICD-10-CM Diagnosis Code CMS notes the following NCD coding changes in […]
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ICD-11 Coding

The Train Has Left the Station: ICD-11 on its Way

New series to focus on preparing for the new code set. ICD10monitor and Talk Ten Tuesdays are launching a new series today, which will continue through November, focusing on the need for early preparation for the new ICD-11 code set that most expect will be ready for the U.S. implementation in 2022. “Now, five years after ICD-10 […]
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Code for Remote Patient Monitoring

Medicare Remote Patient Monitoring: CMS Finalizes New Code and General Supervision

CMS just released the 2020 final rule with changes to remote patient monitoring (RPM), officially titled “Chronic Care Remote Physiologic Monitoring,” reimbursed under the Medicare program, as part of the Physician Fee Schedule changes. The changes, proposed earlier this year, have been hotly-anticipated by digital health companies hoping to see more clarity and flexibility for RPM services. CMS […]
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OPPS Rule

2020 Outpatient Proposals: 5 Rules You Should Know From CMS

Hospital and health system executives should monitor these proposals for provisions that will affect their organizations’ operations. The 2020 annual rule cycle has been active for CMS. Several proposals in the outpatient prospective payment system (OPPS) proposed rule is controversial, although there is at least one provider-friendly change. Here’s a roundup of five regulatory rules […]
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