Another study confirms that medical billing costs in the US significantly exceed those in similar countries, but researchers now know why: coding drives up US administrative spending. Complex coding structures in the US are driving up medical...
More InfoThree tips are all you need to correctly bill allergen immunotherapy, single or multiple antigens. Allergy services, such as those reported with CPT® 95165 Professional services for the supervision of preparation and provision of antigens for...
More InfoWhat to do when the pathology doesn’t correlate to the service provided. The rules for cutaneous (skin) excision coding are straightforward: When the pathology for a lesion is benign, code for excision of benign lesion, 11400-11446; and...
More InfoHow to avoid medical necessity denials and ensure timely payment. Sick visit on the same day as an annual wellness visit (AWV) Reason for denial: Lack of clear clinical documentation regarding why the physician had to go above and beyond what is...
More InfoCMS Releases FAQ for No Surprises Act Implementation, Requirements The No Surprises Act FAQ states that balance billing protections do not apply to individuals with public healthcare coverage and notice and consent forms must be provided and...
More InfoCMS recently released new data on hospital changes of ownership, a health equity plan and said it would end a legal battle with Texas over Medicaid. Becker’s has reported on the following 13 CMS moves since April 8. Finance No hospitals...
More InfoChoosing a proper office visit code can become confusing unless one understands the rules separating preventive medicine and evaluation and management (E&M) coding. Problem-oriented E&M services, office, and other outpatient visit codes...
More InfoA quarterly update for the Clinical Laboratory Fee Schedule (CLFS), issued May 4, includes nine new CPT® codes for proprietary laboratory analyses (PLAs). Medical coding and billing staff that process claims for lab testing should be aware of...
More InfoArrive at the correct procedure code by breaking down the operative report. Even seasoned coding professionals occasionally find it challenging to assign the appropriate ICD-10-PCS codes from the operative report. Mastering the procedural coding...
More InfoFor primary care practices, earning enough revenue to meet overhead expenses and provide quality care has always been a challenge. But practices often make the challenge even greater through sloppy coding and billing, leading to delayed or...
More InfoThe Centers for Medicare & Medicaid Services (CMS) subsidizes healthcare in defined rural environments, paying encounter rates for provided services provided and the overhead required to provide them. However, it’s not free money. Rural...
More InfoMidland Memorial Hospital agreed to pay over $555,000 for a medical coding error that resulted in claims being sent out for reimbursement from the government even though patients did not have a primary COVID-19 diagnosis. The Texas hospital told...
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