Year: 2019

CMS Proposes Payment Changes to Endoscopic Sinus Codes

CMS Proposes Payment Changes to Endoscopic Sinus Codes

The Centers for Medicare & Medicaid Services (CMS) has proposed changes to the payment structure for sinus endoscopy services in the 2020 Physician Fee Schedule (PFS) proposed rule (page 53). Specifically, CMS intends to apply multiple endoscopy rules, similar to those used for colonoscopies, to sinus endoscopy reimbursements. This approach is detailed in MLN Matters […]
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4 Strategies For Accurate Medical Coding & Denial Prevention

4 Front-End Revenue Cycle Revamps You Need For A Competitive Edge

In the crowded healthcare market, smart healthcare leaders must find patient satisfaction advantages everywhere they can. When it comes to patient satisfaction, providing excellent clinical care is a no-brainer. But in a crowded and competitive healthcare market, smart healthcare leaders know that they need an edge everywhere, including an efficient revenue cycle. That’s the case […]
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ICD-10-CM Guidelines

Updates to the 2020 ICD-10-CM Guidelines

Cliff notes for the FY20 ICD-10-CM Guidelines for Coding and Reporting. EDITOR’S NOTE: Senior healthcare consultant Laurie Johnson reported this story live during Aug. 13 edition of Talk Ten Tuesday. The following is an edited transcript of her reporting. Last week, I announced that the 2020 ICD-10-CM guidelines were finally released on Aug. 6, 2019. I […]
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4 Strategies For Accurate Medical Coding & Denial Prevention

4 Strategies For Accurate Medical Coding & Denial Prevention

4 Strategies For Accurate Medical Coding and Denial Prevention Payers typically deny evaluation and management codes (E/M code) on the back end of the billing process, which can cause costly reimbursement recoupments, according to Medical Economics. Four tips to avoid denials caused by inaccurate E/M levels: Make sure the E/M code supports the specific patient encounter. […]
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CMS Proposes Changes to Physician Fee Schedule, Quality Payment Program

CMS Proposes Changes to Physician Fee Schedule, Quality Payment Program

The Centers for Medicare & Medicaid Services (CMS) is proposing changes to the Medicare Physician Fee Schedule (PFS) and the Quality Payment Program as part of its effort to reduce provider burden. “Clinicians are drowning in paperwork and reporting requirements caused by cumbersome government rules and regulations,” said CMS Administrator Seema Verma in a press […]
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Unpacking Proposed Merit-Based Incentive Payment System Changes

Unpacking Proposed Merit-Based Incentive Payment System Changes

CMS recently proposed Merit-Based Incentive Payment System changes in 2020 and beyond, including a new participation framework and higher performance thresholds. CMS is planning to overhaul reporting for the Merit-Based Incentive Payment System (MIPS) in order to make the pay-for-performance program less burdensome and more meaningful to providers, according a recently proposed rule. As reported last week, […]
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Boost Revenue By Getting Coding Right

Boost Revenue By Getting Coding Right

It’s every physician’s worst nightmare: Receive payment for services rendered, but then a payer identifies an aberrant pattern in claims data, audits the records, decides it has overpaid the practice, and recoups those funds. That money you already allocated for overhead, staff salaries, bonuses, or new medical equipment? Gone. With one post-payment audit, you now […]
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