Choosing 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 99202-99215 (along with hospital, observation, and consultative encounters) are for patients who present with signs, symptoms, conditions, diagnoses and/or problems that need to […]
A 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 these codes and pricing. 9 New PLA Codes The following PLA (type of service 5) codes are […]
Arrive 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 system used in the inpatient hospital setting takes practice. Medical coders reporting inpatient services should start by reading the operative report, […]
The 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 health clinic (RHC) leaders must keep track of the services provided and submit yearly totals. They also must submit and process […]
Midland 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 local news source News West9 that it miscoded 87 claims last November and sent those […]
The importance of Artificial Intelligence (AI) in Medical Coding is often understated and also overstating the same is quite difficult.. to get in-depth with how AI is actually bringing changes in MCA, we must get to the basics of what Medical Billing and Coding really are. Medical Coding Medical coding, if we talk about it […]
A 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 Black Book report on revenue cycle management (RCM) system adoption would say that 26 percent of hospitals […]