The Centers for Medicare & Medicaid Services (CMS) issued a policy change modification to the claims processing logic for Modifier 59 Distinct procedural service (and the optional patient-relationship modifiers XE, XS, XP, and XU) on February...
More InfoA frequent knock on electronic health records has been that they’re just glorified billing systems that fail to provide enough clinical functionality to make a significant difference in quality of care. So it’s somewhat incongruous that a recent...
More InfoCryptocurrency benefits medical billing services, and in turn healthcare staff and patients, in so many ways. Here’s what to know A cryptocurrency is a decentralized virtual or digital currency that’s used as a medium of exchange for using...
More InfoControversy continues to swirl around this subject. A recent article of mine focused on the argument that Medicare Advantage (MA) plans have to follow the two-midnight rule. It certainly generated buzz; I received a number of emails with comments...
More InfoUndercoding, or reporting a lesser service than was performed and documented, is sometimes employed as a defensive strategy to stave off claims denials or audits. But, undercoding can make a provider an outlier, and may create consequential...
More InfoAs providers engage in complex payment models and collect more from patients, they must learn to automate key functions to improve healthcare revenue efficiency. The healthcare revenue cycle has many moving parts. From patient access and...
More InfoTechnology can transform data into actionable insights for providers needing to meet the demands of value-based care and consumerism in healthcare. Transforming raw data into actionable information is crucial to the financial future of provider...
More InfoEnding surprise medical bills has risen to a national priority with bipartisan political interest. In January, President Donald Trump directed Cabinet officials to find a solution, and multiple congressional bills were proposed in the last...
More Info“Separate procedure” may not mean what you think. Many procedural codes in the CPT® Book are designated as “separate procedures.” However, the common misinterpretation of this is that coders can report such codes as such in every case. Not true...
More InfoEven as health systems confront rising healthcare costs and declining margins, they are under pressure to improve the patient experience, retain customer loyalty and collect patient payments. But while two-thirds of patients said cost strongly...
More InfoWithout even putting too much effort into listening to or reading the news, you understand that healthcare costs have steadily risen over the last couple decades, and yet we don’t really have any significant and correlating rise in outcomes to...
More InfoUnderstanding the correct use of chronic condition codes in the coding process. Unexpected and inaccurate medical bills can be alarming and shocking. Coders are often confused regarding when they should code co-morbid chronic conditions and when...
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