Despite myths to the contrary, physicians are not prohibited from coding and billing for both preventive and problem-focused evaluation and management (E/M) services when they are performed during the same appointment. Motivated by a desire to...
More InfoCMS issued a proposed rule to update payment rates and policies under the End-Stage Renal Disease Prospective Payment System for renal dialysis services furnished to Medicare beneficiaries on or after Jan. 1, 2023. Here are four takeaways from...
More InfoIt’s important to be realistic about what AI can and can’t do currently. Artificial intelligence (AI) has been a buzzword in payment integrity for years. Companies are increasingly using AI and data mining to identify healthcare savings. This...
More InfoMake sure your facility is aware of all the Medicare policy changes that permit payment for expanded services. Telehealth as a healthcare delivery platform has been in existence since the late 1960s. It was first introduced through projects...
More InfoRecognition of the impact that social determinants of health (SDOH) have on patients’ outcomes is growing, as is the desire to incorporate SDOH factors into patient-care plans. But awareness of an existing data infrastructure that could help...
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 InfoTo see where and how the use of digital health tools is growing, take a look at the Current Procedural Terminology (CPT®) code set, which opened the door to payment for remote patient physiologic monitoring and is now doing the same for remote...
More InfoThe errors identified through coding audits really are a lesson to learn. We all can learn from the past, right? Human nature tells us to do so. This is also true when it comes to healthcare and coding compliance. Haven’t you seen, read, or heard...
More InfoDodge denials for drug testing by knowing which details demand attention. How often do you experience denials when it comes to your definitive drug testing? If the answer is often, this article may provide some answers to why that might be...
More InfoValidating the shift to higher office visit levels and the impact of the 2021 E&M guidelines. Between 2019 and the end of 2021, a lot changed. Not only did the COVID-19 pandemic impact the way in which physicians and hospitals saw patients...
More InfoOn Feb. 11, the World Health Organization (WHO) released ICD-11 2022. This is the official version of the 11th revision of the International Classification of Diseases (ICD) coding set that WHO member countries will be implementing worldwide. In...
More InfoThere are three new codes in the care management section of the CPT codebook, covering principal care management and chronic care management services. Here’s what physicians need to know about them. Principal Care Management Services New CPT...
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