Tag: outsourcing Medical coding

Top Strategies to Prevent Medical Coding Denials

Top Strategies to Prevent Medical Coding Denials

Medical coding denials are a common challenge for healthcare providers and revenue cycle management (RCM) teams. They can disrupt cash flow, delay reimbursements, and increase administrative workloads. Avoiding these denials requires a proactive approach that addresses their root causes, ensures compliance with regulations, and fosters a culture of continuous improvement. In this blog, we’ll explore […]
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Seasonal medical coding challenges

Seasonal Coding Challenges: Managing High-Volume Claims

Healthcare providers and their revenue cycle management (RCM) teams face unique seasonal medical coding challenges during seasonal surges in patient care. These seasonal patterns can generate large volumes of claims that require accurate and efficient medical coding, whether they are caused by flu outbreaks, allergies, or elective procedures scheduled before insurance deductibles reset. Table of […]
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Top 7 Ways Outsourcing Medical Coding Benefits

Top 7 Ways Outsourcing Medical Coding Benefits

Medical coding plays a crucial role in managing the administrative aspects of your organization. It’s evident that without precise medical coding, obtaining reimbursement from insurance companies and third-party entities becomes a challenge. Both under coding and over coding can lead to revenue losses for your organization. While there are avenues for appeals in case of […]
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New Procedure Codes Coming This Fall

New Procedure Codes Coming This Fall

Look for them at a hospital near you. The ICD-10-PCS update for fiscal year 2023 is now available. To prevent coding errors that result in claim denials, inpatient coders should download the code files and familiarize themselves with the changes to inpatient coding that go into effect Oct. 1. The fiscal year (FY) 2023 ICD-10-PCS […]
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When To Report an Incidental Finding

When To Report an Incidental Finding

DOJ lawsuits may be your road map to risk adjustment compliance. The growing prevalence of risk adjustment in healthcare has forged new processes in documentation practices that have resulted in many organizations adopting practices that bend the cast iron rules for ICD-10-CM coding. We are starting to see some of the long-term dangers of ambitiously […]
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Understand Critical Care Before You Code

Understand Critical Care Before You Code

A solid understanding of guidelines and COVID-19-related complexities will limit claim denials and audits. Deciphering documentation to determine what qualifies as critical care services can be challenging for medical coders and auditors. With limited critical care codes available for assignment, reporting may appear relatively straightforward at first glance. However, there are many considerations that coders […]
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