Tag: Physicians

CPT Codes

Six Tips to Getting Paid for CPT Modifiers

CPT modifiers help payers understand all of the distinct services and procedures physicians perform. As the scope of practice for today’s internists continues to expand, these modifiers are also increasingly required to ensure accurate payment, says Toni Elhoms, CCS, CRC, CPC, director of coding and compliance at RT Welter & Associates Inc., a healthcare consulting […]
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  • April 1, 2019

ICD-10, Diagnostic Errors & Payment Reforms to Improve Diagnostic Accuracy

In October 2015, physicians across the United States transitioned from the International Statistical Classification of Diseases and Related Health Problems, Ninth Revision to the tenth revision (ICD-10-CM, the US version of the World Health Organization [WHO] ICD-10). Although the ICD-10-CM was a new concept for physicians in the United States, the international variant has been available since […]
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  • March 6, 2019

Federal Policy to End Surprise Billing: Building on Prior Approaches

Ending surprise medical bills has risen to a national priority with bipartisan political interest. In January, President Donald Trump directed Cabinet officials to find a solution, and multiple congressional bills were proposed in the last Congress with the same goal. Surprise medical bills consist of unanticipated charges from out-of-network clinicians—often when the facility or primary physician is […]
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  • February 28, 2019

Chronic Conditions: Code or Not to Code MCCs

Understanding the correct use of chronic condition codes in the coding process. Unexpected and inaccurate medical bills can be alarming and shocking. Coders are often confused regarding when they should code co-morbid chronic conditions and when they should not. This leads to inaccurate coding of levels, or sometimes missing out on the opportunity of stressing […]
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  • February 27, 2019

How to Avoid and Correct Inaccurate Medical Bills

Unexpected and inaccurate medical bills can be alarming and shocking. Whether it’s hundreds or tens of thousands of dollars, when you get a bill for an ER visit or surgery you already paid or don’t owe, it can sometimes be difficult to get answers from the provider or insurance company. All this week KPRC2 consumer […]
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  • February 13, 2019

New Medicare Enrollment Application

There is a new version of the CMS-855I Medicare Enrollment Application, which physicians and non-physician practitioners may begin using immediately. Medicare Administrative Contractors will accept the previous version of the application (7/2011) through April 30, and then require you to use the new version (12/18). What’s Changed? The Centers for Medicare & Medicaid Services (CMS) has made the […]
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  • January 25, 2019

Are You Neglecting Charge Capture?

Despite calling it “essential,” many healthcare leadership teams discuss charge capture once a month or less. Despite its importance, charge capture doesn’t get the attention that it deserves, according to a survey of revenue cycle leaders. Although 78% of respondents characterize charge capture as “essential” to their organization’s success, leadership teams at 40% of organizations […]
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