Tag: Coding

Key-Insights-for-RCM-Professionals

Driving Revenue Growth: Key Insights for RCM Professionals

The importance of Revenue Cycle Management (RCM) is no longer just a best practice in today’s ever-changing healthcare landscape – it has become a necessity. In a market where costs are rising, regulations are becoming more complex, and patients are becoming more responsible for their own finances, optimizing the revenue cycle is essential to maintain […]
Learn More
EM Coding Guidelines

Comparing 2023 CPT® E/M with Documentation Guidelines

The 1995 and 1997 Documentation Guidelines and the 2023 CPT® E/M Services Guidelines are not drastically different when compared side by side. Some hospitals and coding and billing entities may believe that the new 2023 CPT® evaluation and management (E/M) services guidelines and code changes simplify the coding, billing, and auditing processes. However, it is […]
Learn More
Rules for Coding Emergency Department

CMS Rules for Coding Emergency Department Claims | Best Practices

The Centers for Medicare and Medicaid Services (CMS) has consistently authorized hospitals to establish and utilize their own coding guidelines for emergency department facility claims. CMS makes clear that “[a]s long as the services furnished are documented and medically necessary and the facility is following its own system, which reasonably relates the intensity of hospital […]
Learn More

The Coding Conundrum: Vaping-Related Lung Injury

Confusion persists for the coding of vaping. The Centers for Disease Control and Prevention (CDC) is currently investigating vaping-related illnesses that have recently been reported. There are 450 confirmed or suspected cases in 33 states. The first death was reported on Aug. 23, 2019, in Illinois. The concern has escalated to the point that the […]
Learn More

Medicare Payments For Top 10 ASC Codes Through 2019

Medicare payments for the top 10 current procedural terminology codes performed by ASCs are expected to remain relatively stable in 2019 compared to 2018, according to VMG Health. 66984: Cataract surgery with insertion of intraocular lens prosthesis (one-stage procedure), manual or mechanical technique Estimated 2017 payments: $1,172 Estimated 2018 payments: $1,206 Estimated 2019 payments: $1,182 45380: […]
Learn More

How to Appeal for Denied Claims

Effective appeals often hinge on how you present your case to the insurance carrier. Here are essential guidelines to ensure your appeals are successful: Be Prepared: Anyone representing your case in an appeal—whether it’s a coder, biller, office manager, or provider—should be well-informed and equipped with detailed information. They should be capable of discussing the […]
Learn More
x