Tag: Allzone Management Services

New Coding Issues to Confront Coders

New Coding Issues Emerge To Confront Coders

  The new codes and subsequent issues will be effective Oct. 1, 2023. According to senior healthcare consultant Laurie Johnson, who presented the information during the series, three major issues emerged from her research and manifested themselves in her presentation —a presentation that was augmented with commentary from Erica Remer, MD, co-host for the long-running […]
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Final Surprise Billing Rules QPA

Biden Administration Releases Final Surprise Billing Rules

The final surprise billing rules downgrade the weight the QPA has on out-of-network payment determinations and establishes documentation requirements for down coding situations. The Biden Administration has released final surprise billing rules implementing the No Surprises Act, a federal law enacted in January 2021 that protects patients from out-of-network medical bills when they seek care […]
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Prior-authorizations-and-MedPAC-recommendations

Prior Authorizations and MedPAC Recommendations: MGMA’s view

Prior authorizations and Medicare reimbursements are some of the most consistently cited sources of issues at primary care practices. Anders Gilberg, senior vice president of government affairs for the Medical Group Management Association (MGMA), joined us in April to discuss his organization’s lobbying efforts. The following interview has been edited for length and clarity. Medical […]
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Value-based-revenue-on-primary-care-income

Value-Based Revenue Makes up 6.74% of Primary Care Income

MGMA report shows value-based contracts account for $30,922 per provider The Medical Group Management Association released a report looking at the proliferation of value-based contracts and how quality metrics tie-in to revenue. The report, 2022 MGMA DataDive Practice Operations, shows that revenue from value-based contracts accounted for varying amounts of total medical revenue in 2021 […]
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Locum-Tenens-Physicians-to-fill-vacant-positions

Locum Tenens Physicians To Fill Vacant Positions

  Hospitals are increasingly utilizing locum tenens physicians, advanced practice providers (APPs), and telehealth services to address staffing shortages. The Innovation & Flexibility: Journey to Sustainable Healthcare Report reflects data from 129 healthcare administrators representing a range of facility types and sizes. The COVID-19 pandemic exacerbated hospital staffing shortages as many clinicians faced burnout and […]
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Medical-Necessity-Code-Changes-ICD-10-CM

NCDs Affected by ICD-10-CM Medical Necessity Code Changes

When ICD-10-CM is updated Oct. 1, so are these National Coverage Determinations. Are you wondering which National Coverage Determinations (NCDs) will be affected by the thousands of diagnosis code changes going into effect Oct. 1? Centers for Medicare & Medicaid Services (CMS) transmittal tells all. CMS Transmittal 11546, issued Aug. 4, is a one-time notification […]
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Physician-Fee-Schedule-Proposed-Rule-2023

Newly Revised CPT E&M Guidelines: Physician Fee Schedule Proposed Rule

A major revision of the Current Procedural Terminology (CPT) Evaluation and Management (E&M) Guidelines for Office and Outpatient Visits (O/O Visits), Split/Shared Visits, and Critical Care Time billing was implemented Jan. 1, 2021. You would think that all office-based providers would have been made aware of this and changed their documentation accordingly, but there is […]
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Clinical-Coding-Changes-ICD-10-CM-PCS

Clinical Coding Changes: ICD-10-CM/PCS C&M Committee

Throughout the years in the health information management field, we’ve always been deeply interested in clinical coding and even find clinical coding to be fun. With that comes learning about the annual coding changes: new, revised and deleted codes. That brings us to the ICD-10-CM/PCS Coordination and Maintenance (C&M) Committee, how they work and the […]
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