E&M codes are the most frequently used codes in any physician practice. Change is coming to the world of evaluation and management (E&M) services. With the Physician Fee Schedule Final Rule for 2020 now published, we know there are big changes to be expected in 2021. The good news is that there’s a year to […]
HCCs thrive on specificity and ICD-11 will provide a higher level of specificity than in ICD-10. For those of you who are HCC coding for hierarchical condition category (HCC) purposes, you know that HCCs are categories of related ICD-10 codes. Only selected significant conditions to drive a payment HCC coding. That means only conditions that […]
Three new HCPCS Level II G codes are added to the Medicare Telehealth Services list for Calendar Year (CY) 2020. These codes describe new bundled services for the treatment of opioid use disorders (OUD). The Centers for Medicare & Medicaid Services (CMS) states in the 2020 Physician Fee Schedule final rule, “By creating a separate bundled payment […]
You are indeed correct that ICD-10 coding makes its updates on Oct. 1 for the following year. This means the codes actually update on that date and any date of service on or after Oct. 1 must use the new or updated code to be valid. CPT codes or procedure codes actually do not update […]
Tips for improving outpatient billing, coding and CDI. In moving from inpatient clinical documentation improvement (CDI) to outpatient CDI, I have been discovering some unique educational pointers. I know we are all very busy, so let’s just dive right into it. Doctors and coders, you should not have diagnoses that are mutually exclusive to one […]
PH WHO groups key to understanding I27 codes. Despite the fact that pulmonary hypertension (PH) is a “frequently identified … highly morbid condition … associated with increased mortality, hospitalizations and financial burden,” it is “rarely coded in the EHR [Electronic Health Record]” according to a recent article published in the Journal of Cardiac Failure. What, then, can you […]
The final rule for the CY 2020 End-Stage Renal Disease (ESRD) Prospective Payment System will boost Medicare reimbursement to encourage dialysis innovation. CMS last Thursday finalized a rule that will bump the bundled Medicare reimbursement rate for end-stage renal disease (ESRD) providers by $4.06 in 2020 and create a transitional add-on payment adjustment for certain new dialysis […]
Centers for Medicare & Medicaid Services (CMS) unveiled the HCPCS Level II code modifications for 2020 on November 8th. These alterations encompass an extensive array of fresh, revised, and eradicated codes, serving as the means to document Medicare Part B services. The 2020 HCPCS Level II edition is set to incorporate a total of 191 […]
Now is the time to begin preparing for the new code set. It is good to be back to talk about ICD-11. Yes, it’s a reality now, and all providers can start to get prepared for this significant new ICD-11 coding system. ICD-11 has been years in the making, and it is a result of […]
88% of providers are eager to implement clinical document improvement technology that leverages AI, and 93% believe the systems can streamline document creation. Forty-four percent of healthcare organizations already use artificial intelligence (AI) in one form or another, and more hospitals are looking to apply the technology to coding and clinical documentation improvement, a recent […]