The Comprehensive Error Rate Testing (CERT) program grew out of the Department of Health and Human Services Office of Inspector General improper payment rate estimates from 1996 through 2002. Due to sample size restrictions, the Centers for...
More InfoOverlooking separately billable services rendered during the global period will cost your practice dearly. Many obstetrics/gynecology (OB/GYN Coding) practices are coding deliveries incorrectly or failing to submit claims for “problem visits”...
More InfoDenied claims are one of physicians’ chief complaints when it comes to dealing with payers. To a certain extent, every practice deals with claim denials. It’s those practices that eliminate the most common reasons that experience a...
More InfoIn October 2015, physicians across the United States transitioned from the International Statistical Classification of Diseases and Related Health Problems, Ninth Revision to the tenth revision (ICD-10-CM, the US version of the World Health...
More InfoE&M code changes are expected to become effective in 2021. The American Medical Association (AMA) released on March 8 the summary of panel actions that took place at the February 2019 CPT® panel meeting. The exact wording is not considered to...
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 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...
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