Year: 2019

Is It Possible to Make OB Coding Less Complicated

Is It Possible to Make OB Coding Less Complicated?

Just like our patients, proper OB coding and billing for obstetric patients can be…complicated. As a coding instructor and compliance auditor, I field a lot of questions from new students and experienced billers alike. In this article, I’ll break down a few of the most important concepts you need to understand to master obstetric coding. […]
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Effective And Profitable Chronic Care Management

How To Deliver Effective And Profitable Chronic Care Management

Chronic care management (CCM) has an overarching clinical goal—improving the health of Medicare patients with multiple chronic conditions. Besides knowing the service parameters, pay rates and usage requirements for CCM codes, physicians must understand how to effectively bill for CCM in order to profitably achieve that goal. Medicare pays for CCM (typically, non-face-to-face) services to […]
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Medical Necessity and Denial Management

Medical Necessity and Denial Management

Quality work reduces the burden of the denial management process. When my children were young, they really enjoyed the movie “The Neverending Story.” It’s about a boy who reads a magical book that tells a story of a young warrior whose task is to stop a dark force called “The Nothing” from engulfing a mystical […]
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Medicare Advantage And The Future Of Value-Based Care

Medicare Advantage And The Future Of Value-Based Care

The Medicare Advantage (MA) program, which allows Medicare beneficiaries to voluntarily enroll in a private plan that administers health benefits, was established by the Balanced Budget Act (BBA) of 1997 as a vehicle to bring private-sector competition and innovation to Medicare beneficiaries. When the program was announced, the goal was to create greater competition on […]
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Hundreds of New ICD-10-CM Codes

Hundreds of New ICD-10-CM Codes Effective Oct. 1

The Centers for Medicare & Medicaid Services (CMS) released on June 20 the new ICD-10-CM codes descriptions, tables and index, and addendum for fiscal year 2020. There are 273 additions, 21 deletions, and 30 revisions, effective Oct. 1, 2019, which will increase the code set from 71,932 to 72,184 diagnoses. Chapter Review The majority of changes to new […]
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A Patient-Centered Approach To Revenue Cycle Tech Strategy

A Patient-Centered Approach To Revenue Cycle Tech Strategy

A strategic approach to patient-centered revenue cycle technology strategy should be enabled by predictive analytics and machine learning to help customize the payment experience, refine communication messages, and give proper feedback to continually improve back-end processes. The path to financial health for hospitals and health systems has shifted and is rematerializing in a way that […]
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