A thorough understanding of the latest guidelines for coding evaluation and management services is necessary to ensure compliant claims. You’ve likely heard about the 2023 CPT® changes for reporting hospital inpatient and observation evaluation and management (E/M) services. AAPC has been preparing medical coders for these changes since they were announced and started offering education […]
Attendees at AAPC’s AUDITCON, Nov. 3-4, 2022, came loaded with questions about the coding and guideline changes for evaluation and management (E/M) services in CPT® 2023. The conference offered several sessions on the subject, including the ED session, “Changes in 2023: Emergency Department,” presented by AAPC Chief Product Officer. The officer provided a high-level overview […]
In a year when many people have very few resources, it is important for healthcare organizations to strategically identify areas of concern on a unique and broader spectrum. Healthcare business owners and clinicians, from the front desk to the C-suite, should at a minimum conduct a risk assessment of these areas and ultimately have policies […]
The patient financial experience and No Surprises Act are top of mind for revenue cycle leaders as we move into 2023. As hospitals try to navigate the COVID-19 crisis, inflation, labor shortages, and rising expenses, organizations are going to finish out the year in the red, according to the latest National Hospital and Physician Flash […]
The number of prior authorization requests continues to increase — despite promises to the contrary by payers — costing physicians time and money. A Medical Group Management Association (MGMA) poll found that 70% of medical groups indicated that prior authorizations increased in the last year. Physicians say that their practices continue to struggle with either […]
Providing care management services, including chronic care management (CCM) and principal care management (PCM), is not easy. The first overarching challenge is that not enough patients actually participate in care management with a primary care physician. In fact, A recent report from the Primary Care Collaborative and the American Academy of Family Physicians’ more Americans […]
E/M, Gastro, and Lab Coders, take note. The American Medical Association (AMA) announced some last-minute corrections to the CPT® code set effective Jan. 1, 2023. Add these to your code book, along with the previously released corrections, to ensure you start the year off right with accurate codes and guidelines. Evaluation and Management (E/M) In […]
Quality metric reporting can be a significant challenge to health care administration due to a number of obstacles. First and foremost, you need buy-in from the physicians providing the care to the patients. Without this, it is difficult to make any meaningful changes to the pattern of care provided. Second, it requires having a very […]
Health care leaders are anticipating a turbulent 2023, according to a report. Staffing, inflation, shrinking margins, and supply chain issues are among the top concerns that will continue to challenge hospitals and health systems and have an outsized effect on overall strategy. Here are the four factors identified as being the most likely to impact […]
The American Hospital Association (AHA) and Better Medicare Alliance (BMA) both support the agency’s effort to improve Medicare Advantage (MA). In an attempt to reform MA, CMS released a proposed rule that aims to streamline prior authorization, promote health equity, and curb deceptive marketing. The Biden administration has shown a commitment to increasing oversight of […]