Tag: EHR

AI and EHR Perfect Together

AI and EHR: Perfect Together?

Big data and electronic health records — along with other technologies — could change the way long-term care is delivered. We’re living in an age of unprecedented technology. Back in the 1960s, when most of the residents at your long-term care facility were establishing their careers and rearing children, the first computers began appearing in […]
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What Happens When EM Guidelines Change

What Happens When E/M Guidelines Change?

Medical coders, billers, auditors, and other healthcare business professionals started Day 2 of AAPC’s Regional Conference in New York City getting the scoop on the proposed changes to evaluation and management (E/M) services coding and E/M guidelines. E/M Guidelines Changes Are About Time Conference attendees were eager to hear Raemarie Jimenez, CPC, CDEO, CIC, CPB, CPMA, […]
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4 Strategies For Accurate Medical Coding & Denial Prevention

4 Strategies For Accurate Medical Coding & Denial Prevention

4 Strategies For Accurate Medical Coding and Denial Prevention Payers typically deny evaluation and management codes (E/M code) on the back end of the billing process, which can cause costly reimbursement recoupments, according to Medical Economics. Four tips to avoid denials caused by inaccurate E/M levels: Make sure the E/M code supports the specific patient encounter. […]
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electronic health record

Is Your EHR Ready For PDGM?

When the Patient-Driven Groupings Model (PDGM) launches Jan. 1, 2020, leveraging tools and resources to ensure compliance will be critical to a successful transition. Home health care providers already have one helpful tool in place: the electronic health record (EHR). By incorporating workflow efficiencies, alerts, customizable features and feedback reporting capabilities, EHRs can provide visibility […]
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AMA on Evaluation and Management Service Codes Guidelines

AMA on Evaluation and Management Service Codes Guidelines

Medical coders who were unsure what documentation non-Medicare payers would expect in light of the Patients Over Paperwork Initiative now have more to go on. The initiative reduced documentation requirements for outpatient evaluation and management service codes (CPT® 99201-99215) provided to Medicare Part B patients beginning in 2021. The Centers for Medicare & Medicaid Services (CMS) indicated in their initiative that, although […]
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The Facts Surrounding The Coding Chronic Kidney Disease

The Facts Surrounding The Coding Chronic Kidney Disease

Chronic Kidney Disease (CKD) is a serious health condition affecting millions of people worldwide. In the United States alone, 15% of adults, or approximately 37 million people, suffer from CKD. This condition, often insidious in its onset, can lead to severe complications and significantly impact quality of life. Key Facts about CKD: Prevalence: More common […]
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New Rules Issued for Modifiers 59, XE, XS, XP, and XU

New Rules Issued for Modifiers 59, XE, XS, XP, and XU

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 15, 2019. These modifiers are only processed when applied to the Column 2 code in a bundled pair, per Correct Coding Initiative […]
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Medicare Advantage Plans and the Two-Midnight Rule

Medicare Advantage Plans and the Two-Midnight Rule

Controversy 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 and questions. First, I want to note that I love getting comments and questions. I can’t […]
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