Category: Blog

H5N8 Avian Influenza Vaccine

New CPT Codes Streamline Vaccination for H5N8 Avian Influenza

H5N8 Avian Influenza Vaccine: The American Medical Association (AMA) has updated the Current Procedural Terminology (CPT) code set to include new codes for vaccines protecting against the H5N8 strain of avian influenza. This update follows a recent global outbreak of avian influenza, particularly the H5N1 strain, which has affected wild birds, poultry, dairy cows, and […]
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Billing Codes for MRI

2025 Billing Codes Proposed for Complex MRIs with Implants

CMS is proposing new Billing Codes for MRI in the draft 2025 Medicare Physician Fee Schedule to account for the extra work involved in safely performing MRIs on patients with implants or other factors that could pose risks. These additional tasks might involve reviewing a patient’s medical history, researching implant specifics, carefully considering risks and […]
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Value based payment

Value-Based Payment: Prioritizing Patient Health Over Profits

Value-Based Payment: Putting Patient Health First: When recommending a medical procedure, should doctors prioritize insurance reimbursements or patient health? The answer hinges on the payment model. In a fee-for-service system, providers are compensated for each individual service, potentially incentivizing excessive care. This model can lead to increased costs and harm patients through unnecessary treatments or medications. […]
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Prior Authorization Requirements

Physician Discovers Hidden prior authorization Details in CPT Codes

A proposal to track prior authorization using CPT codes was pulled back for revision after a surprising finding. An urologist, advocated for the plan to compensate physicians for time spent on prior authorization requirements. He also hoped it would streamline the process and improve patient care. However, the American Medical Association (AMA) informed urologist that […]
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physician practice RCM

RCM in Physician Practices: Key Steps Revealed by AMA

Physician RCM: This guide dives into key areas physician private practices can target to strengthen their revenue cycle management (RCM), as outlined by the American Medical Association (AMA) in recent News. By optimizing these eight steps, practices can ensure timely and accurate reimbursement for services provided. 1. Patient Registration: Accuracy First The foundation of a […]
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Retina Injection coding

Master Retina Injection Coding for Smooth Billing & Reimbursement

Accurate coding is essential for retina practices performing intravitreal injections, especially when handling retina injection coding. While medication and modifier updates occur frequently, understanding these basics ensures proper reimbursement: CPT® Code Consistency: CPT® code 67028 remains constant for administering the medication. HCPCS Level II Code Tracking: Codes for injected drugs (HCPCS Level II) vary and […]
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Cyberattack on Change Healthcare: HIPAA Breach Notification

Following a major cyberattack on Change Healthcare, a subsidiary of UnitedHealth Group (UHG), confusion arose regarding who would handle the Change Healthcare cyberattack HIPAA breach notification for potentially millions of affected individuals. HIPAA regulations govern such notifications, but the situation presented unique challenges. In May 2024, the Department of Health and Human Services (HHS) issued […]
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ICD-10-CM coding

Top 10 ICD-10-CM Coding Errors

Medical ICD-10-CM coding accuracy is crucial for efficient healthcare reimbursement. Even minor errors can lead to claim denials, delays, and lost revenue. Here are the top 10 medical coding mistakes to avoid: Accuracy is Key: 1. Don’t Skip the Details: ICD-10-CM codes often require specific details in the fourth and fifth digits. Using truncated codes […]
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