Tag: Medical Coding Services

Can-you-bill-EM-from-the-same-appointment-Image

Can you bill E/M from the same appointment?

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 avoid audits, many physicians tend to undercode for the work they perform. Others, however, are just unaware that the idea that […]
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Updates on End-Stage Renal Disease Prospective Payment copy

Updates on End-Stage Renal Disease Prospective Payment

CMS 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 the proposed rule: Under the proposed rule, Medicare expects to pay $8.2 billion to approximately 7,800 facilities […]
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What AI Can and Can’t Yet Do in Payment Integrity

It’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 technology can be helpful in the right scenarios. Data versus Nuance AI, which includes technologies like machine […]
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Regulations Open Doors for Telehealth Services in FQHCs

Make 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 initiated by the National Aeronautics and Space Administration (NASA) and the Nebraska Psychology Institute. The declaration of […]
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Don’t Overlook These New PLA Codes

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 […]
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key-factors-when-coding-drug-screenings

Key Factors When Coding Drug Screenings

Dodge 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 happening. Many payer policies have very clear guidelines, both medical and reimbursement, that dictate […]
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ICD-11 Officially Released for Implementation

On 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 fact, according to the WHO release announcement, 35 countries are already using ICD-11. The WHO began developing […]
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