Tag: Reimbursement

April 2024 HCPCS Level II Code

April 2024 HCPCS Level II Code Update

The official April 2024 update to the HCPCS Level II code set is now available on the Centers for Medicare & Medicaid Services website.  April update includes: 62 new codes 2 changes to scope and long description 21 obsolete codes 11 changes to long description 1 change to changes miscellaneous changes Below are some  code […]
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Tips to Avoid Billing Errors in Radiology Practices

Have you ever received a medical bill that left you perplexed, questioning how the expenses added up and left you scratching your head? If that’s the case, you’re certainly not alone. Billing for radiology can be intricate and confusing, involving numerous codes and procedures. Unfortunately, errors in medical billing are all too frequent, resulting in […]
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2021 Surgical Modifiers

Append Surgical Modifiers With Confidence

Modifiers 79: Know how to differentiate modifiers 79, 78, and 58to ensure proper reimbursement for all procedures performed. Modifiers convey important information about a claim and can directly affect reimbursement. But choosing the most appropriate modifier can be confusing — especially when two or more modifiers have similar descriptors. Modifiers 58, 78, and 79 are all […]
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Denials Management v Denials Avoidance

Denials Management Versus Denials Avoidance: CDI Can Capitalize

  Typical CDI programs are intended to drive reimbursement through diagnosis securement, contributing to improved case mix index. The COVID-19 pandemic is placing monumental financial stressors upon hospitals, with added costs to treat patients with high acuity and long length of stays, coupled with significant revenue loss associated with postponement of more profitable elective surgeries, […]
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AI in COVID19 Pandemic

How AI is Solving Big Challenges During COVID-19

Artificial intelligence is changing the way we think about healthcare during the COVID-19 pandemic, opening our eyes to new opportunities to use machine learning to draw useful conclusions faster. Before COVID-19, one of the biggest challenges healthcare organizations faced was how to accelerate and scale their application of AI—clinically and operationally. Now, the use cases […]
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Denials Management Plan

6 Action Items for Your Denials Management Plan

There’s so much noise around denials management that it can be hard for even the most seasoned revenue cycle executives to cut through the clutter, find clear solutions, and make a solid plan. But that’s exactly what Kimberly Scaccia, vice president of revenue cycle at Mercyhealth in Wisconsin and Illinois, helped listeners do last month during a HealthLeaders webinar sponsored by Change […]
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RCM Automation

Transforming Revenue Cycle Management Using Automation

In today’s healthcare industry today, there is a lot of buzz and hype surrounding automation. Large healthcare networks, medical facilities, and revenue cycle management service providers alike are looking to achieve a more efficient, robust revenue cycle through automation technologies. Any technology that can free employees to focus on high-value tasks and make revenue cycle […]
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2021 MPFS & Policy Upda tes

A View into Proposed Medicare PFS and Policy Changes for 2021

  The Centers for Medicare & Medicaid Services (CMS) in the past week has proposed Medicare payment rules for outpatient services and physicians for 2021 and finalized payment rules for inpatient rehabilitation facilities (IRFs) and psychiatric facilities. Looking specifically at the 2021 Physician Fee Schedule (PFS) proposed rule, scheduled to be published Aug. 17, it […]
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