The final rule is an implementation of the No Surprises Act, which was passed by Congress last year. The U.S. Department of Health and Human Services issued an interim final rule this week banning surprise medical bills and some out-of-network charges, which will go into effect on January 1, 2022 for providers and insurance […]
Physicians enter into health care because they want to help care for patients, not to become business people. This can make revenue cycle management (RCM) seem like an overwhelming or complex set of steps, yet, at its essence, “it is basically about obtaining payment for services rendered to a patient,” says Kelly Dingwell, principal attorney […]
Our hospital has been denied CPT code 52601 because the operative report does not mention the word complete. Although the operative note described the procedure in detail and the pathology report showed benign prostatic hyperplasia (BPH) tissue, why do we need to state the word complete? What does it mean in the CPT description? CPT […]
Healthcare consumerism is on the rise , as patients report the desire to use telehealth and contactless payment options post-COVID-19. However there are disconnects between payer, provider, and consumer expectations, according to the eleventh annual Trends in Healthcare Payments Report from InstaMed. The report explores how COVID-19 has accelerated many trends that have improved the consumer experience […]
A bill introduced last week in the House of Representatives could extend the moratorium on Medicare sequestration. The moratorium, which prevents a 2 percent Medicare cut, is scheduled to end March 31, but House Bill 1868, introduced March 12, would extend that deadline until Dec. 3. The bill currently has been referred to a […]
Physicians are asking for adequate reimbursement for all COVID-19 vaccines and their administration, according to a new policy statement from the American College of Physicians (ACP). The statement released on Jan. 12 calls on health policymakers to require insurers to “provide adequate reimbursement for all vaccines, including COVID-19 vaccines, administered according to” scientific guidelines established by […]
In anticipation of an emergency use authorization from the Food and Drug Administration (FDA), the American Medical Association (AMA) has created Current Procedural Terminology (CPT) codes for AstraZeneca’s COVID-19 vaccine. AMA assigned Category 1 CPT code 91302 to the vaccine manufactured by the Cambridge, United Kingdom (UK) company, as well as vaccine administration CPT codes […]
A version of this article was first published December 14, 2020, by HCPro’s Revenue Cycle Advisor, a sibling publication to HealthLeaders. CMS recently released two new HCPCS Level II codes for Regeneron’s antibody drugs casirivimab and imdevimab, effective for dates of service on or after November 21. The creation of the new codes comes […]
Healthcare information technology is the approach of information technology to healthcare; it refers to the electronics systems that healthcare professionals utilize to store, share, and analyze the health information. The adoption of health information technology has shown to improve the quality and effectiveness of healthcare, and it promotes individual and public health while bettering the […]
Q: Do the new 2021 coding rules for office visits apply to all payers or just Medicare and Medicaid? Also, are these rules just for office visits, or can we use them for hospital visits, nursing home services, and home visits? A: The changes to the documentation requirements are for codes 99202-99215 only and are […]