Category: Medical Coding

4 Strategies For Accurate Medical Coding & Denial Prevention

4 Strategies For Accurate Medical Coding & Denial Prevention

4 Strategies For Accurate Medical Coding and Denial Prevention Payers typically deny evaluation and management codes (E/M code) on the back end of the billing process, which can cause costly reimbursement recoupments, according to Medical Economics. Four tips to avoid denials caused by inaccurate E/M levels: Make sure the E/M code supports the specific patient encounter. […]
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ICD-11

ICD-11 Is Looming – 8 Steps To Prepare

The newest version of the International Classification of Diseases, ICD-11, is set to take effect in January 2022, according to Software Advice, a business solutions company. Software Advice created a timeline to help providers prepare for the transition: December 2019: Become familiar with the new International Classification of Diseases chapters and codes. January 2020: Communicate with revenue […]
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CMS Proposes Changes to Physician Fee Schedule, Quality Payment Program

CMS Proposes Changes to Physician Fee Schedule, Quality Payment Program

The Centers for Medicare & Medicaid Services (CMS) is proposing changes to the Medicare Physician Fee Schedule (PFS) and the Quality Payment Program as part of its effort to reduce provider burden. “Clinicians are drowning in paperwork and reporting requirements caused by cumbersome government rules and regulations,” said CMS Administrator Seema Verma in a press […]
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Boost Revenue By Getting Coding Right

Boost Revenue By Getting Coding Right

It’s every physician’s worst nightmare: Receive payment for services rendered, but then a payer identifies an aberrant pattern in claims data, audits the records, decides it has overpaid the practice, and recoups those funds. That money you already allocated for overhead, staff salaries, bonuses, or new medical equipment? Gone. With one post-payment audit, you now […]
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Global Surgery & Related Service

Procedural Codes: Global Surgery & Related Services

Multiple Surgeries Multiple surgeries are separate procedures performed by a physician on the same patient at the same operative session or on the same day. Multiple surgeries are distinguished from procedures that are components of or incidental to a primary procedure. Intraoperative services, incidental surgeries or components of surgeries will not be separately reimbursed. Reimbursement […]
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Is It Possible to Make OB Coding Less Complicated

Is It Possible to Make OB Coding Less Complicated?

Just like our patients, proper OB coding and billing for obstetric patients can be…complicated. As a coding instructor and compliance auditor, I field a lot of questions from new students and experienced billers alike. In this article, I’ll break down a few of the most important concepts you need to understand to master obstetric coding. […]
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Hundreds of New ICD-10-CM Codes

Hundreds of New ICD-10-CM Codes Effective Oct. 1

The Centers for Medicare & Medicaid Services (CMS) released on June 20 the new ICD-10-CM codes descriptions, tables and index, and addendum for fiscal year 2020. There are 273 additions, 21 deletions, and 30 revisions, effective Oct. 1, 2019, which will increase the code set from 71,932 to 72,184 diagnoses. Chapter Review The majority of changes to new […]
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