Category: Blog

Non-essential Surgery Guidelines

COVID-19 Causes CMS to Issue Non-essential Surgery Guidelines

CMS wants all providers to cancel or postpone all low-acuity surgeries. The Centers for Medicare & Medicaid Services (CMS) is limiting “all non-essential planned surgeries and procedures, including dental, until further notice,” according to statement the agency released March 18. This measure is designed to have a twofold effect: increase the amount of ventilators and […]
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Regulations on SNF Waivers and Telehealth

COVID-19 Impacts Regulations on SNF Waivers and Telehealth

As with last week, RACmonitor asked Dr. Ronald Hirsch, vice president of R1 RCM, to summarize the most pertinent regulatory changes recently arising. The following is a transcript of his reporting today on Monitor Mondays. “First, thank you, everyone, for continuing to care for patients and continuing to take this pandemic seriously,” Dr. Ronald Hirsch […]
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COVID 19 Has New Code

COVID 19 Has New Code in April

  Coordination and Maintenance committee meeting announces COVID 19 code effective April 1, 2020. The Coordination and Maintenance Committee Meeting announced that the COVID-19 code that was originally scheduled to become effective October 1, 2020 will now be effective April 1, 2020. The code that will be effective is U07.1.  The effective date was changed […]
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COVID-19 Is Upending the Revenue Cycle

3 Ways COVID-19 Is Upending the Revenue Cycle

The pandemic crisis is disrupting the revenue cycle, including the revenue ramifications of cancelling elective procedures. The global COVID-19 pandemic has sent the entire world into turmoil, including negatively affecting the U.S. economy, causing a ripple effect down to healthcare organization revenue cycles. Many elements of this crisis are already changing the revenue cycle, from […]
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ICD-10-CM, New Lab Testing Codes for Covid-19

How to Use ICD-10-CM, New Lab Testing Codes for Covid-19

The introduction of 2019-nCoV Coronavirus, SARS-CoV-2/2019-nCoV (COVID-19) in the United States has produced an influx of patients into the health care system. While knowing how to diagnose and treat these patients is vital, being able to appropriately capture this information for data tracking and payment also is important. The National Center for Healthcare Statistics has […]
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Mastering Revenue Cycle Management

Mastering Revenue Cycle Management

Doctors are fond of complaining that they didn’t go to medical school in order to practice business, but independent physicians do spend much of their time on their practices’ finances. That requires mastering revenue cycle management (RCM), the financial process practices use to administer all the functions associated with claims processing, payment, and revenue generation. […]
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HIPAA Privacy Sanctions

HHS Waives Certain HIPAA Privacy Sanctions

Certain HIPAA sanctions and penalties are being waived for hospitals during the nationwide emergency concerning COVID-19. Which Privacy Rule Provisions Are Waived? Effective March 15, 2020, covered hospitals will not be held to comply with the following provisions of the HIPAA Privacy Rule: The requirements to obtain a patient’s agreement to speak with family members […]
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Medical Code Change for Influenza Season

Code Change for Influenza Season 2020-2021

The 2019-2020 influenza season is winding down, so now is a good time to start preparing for the 2020-2021 influenza season. Let’s start with a new CPT® code for the flu vaccine. Flu Activity Report The Centers for Disease Control and Prevention (CDC) reports that viral activity is decreasing in the United States. According to […]
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Common Revenue Cycle Issues

3 Twists on Common Revenue Cycle Issues

Denials, automation, and surprise billing are perennially tricky & common revenue cycle issues, but new twists on those topics add an extra layer of complexity. When it comes to revenue cycle management, a handful of common revenue cycle issues are nearly always a struggle, year after year. For instance, denials, automation, and surprise billing are […]
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Billing and Coding for Coronavirus_ 7 things to know

Billing and Coding for Coronavirus: 7 things to know

CMS has released several fact sheets in recent weeks on billing and coding to provide guidance to healthcare organizations testing and treating patients for COVID-19, the disease caused by the novel coronavirus. Seven things to know: CMS developed Healthcare Common Procedure Coding System code U0001 to allow laboratories and healthcare providers to bill for using the CDC’s […]
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