Category: Blog

The New ICD-11 Codes: What You Need to Know

The New ICD-11 Codes: What You Need to Know

In the ever-evolving field of healthcare, accurate diagnosis and effective treatment depend on a universal coding system that provides a common language for medical professionals worldwide. The International Classification of Diseases (ICD) serves as the backbone of this system, and with the recent transition to ICD-11, a new era of coding has begun. In this […]
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Latest Diagnosis Coding Guidelines for 2024

Latest Diagnosis Coding Guidelines for 2024

Review the changes to ensure that ICD-10-CM codes are reported accurately On July 5th, The National Center for Health Statistics released the 2024 update to the ICD-10-CM Official Guidelines for Coding and Reporting. It is recommended that medical coders and auditors review these guidelines on an annual basis to ensure accurate reporting of patient conditions […]
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The Impact of Technology on Healthcare Management

The Impact of Technology on Healthcare Management

To efficiently manage healthcare, it is imperative for systems and management teams to maintain a continuous focus on becoming leaner. Healthcare administrators are responsible for overseeing an increasing number of hospitals, clinics, and medical facilities. Their responsibilities include managing operations, facilities, accounting, and policy, as well as evaluating and recommending new technology to improve patient-centered […]
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CMS Proposed Payment Cut to Home Health Agencies

CMS Proposed Payment Cut to Home Health Agencies

Part of the reason for the decrease is attributed to a permanent adjustment in behavior assumptions. The 2024 Home Health Prospective Payment System Rate Update proposed rule released on June 30 revealed that Home Health Agencies will experience a 2.2% payment decrease in 2024 compared to 2023, partly due to a permanent behavior assumption adjustment. […]
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How Outsourced Medical Billing Services Improve Your Bottom Line

How Outsourced Medical Billing Services Improve Your Bottom Line

Outsourcing medical billing services can be an effective strategy to improve the financial health of your healthcare practice. By delegating the billing and coding tasks to a specialized third-party provider, you can streamline your revenue cycle, reduce administrative burdens, and enhance your profitability. However, medical billing can be a complex and time-consuming task that requires […]
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How to Bill an E/M With a Minor Procedure

To determine the appropriate use of modifier 25, review this case study in otolaryngology. The Cigna Group has delayed the requirement for submitting documentation with claims that involve a 25 modified offices or other outpatient evaluation and management (E/M) service (CPT® 99212-99215) and a minor procedure. Despite the payer not enforcing this requirement, physician practices […]
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The Future Impact of EHR Interoperability on Health Care IT: A Look into 2023 and Beyond

The Future Impact of EHR Interoperability on Health Care IT: A Look into 2023 and Beyond

After years of longing for an update, the U.S. healthcare system is finally undergoing the crucial modernization it desperately needs. Dedicated IT professionals within healthcare organizations are now diligently developing enhanced electronic health records (EHRs) that promise increased efficiency and effectiveness. This transformative process entails integrating EHRs with state-of-the-art patient-access technologies. Consequently, various healthcare practitioners, […]
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Prior Authorization in Medicare Advantage : Lawmakers Call for Streamlined Process

CMS has proposed a rule to simplify prior authorization in government-sponsored health insurance programs. However, some lawmakers are urging the agency to do more. A bipartisan coalition of 233 representatives and 61 senators have written a letter to CMS requesting that the proposed rules be expanded and that the changes be finalized quickly to enhance […]
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How Adapting Risk Adjustment Coding Can Change Healthcare Landscape?

How Adapting Risk Adjustment Coding Can Change Healthcare Landscape?

Risk adjustment coding plays a vital role in the healthcare sector by capturing and documenting the severity of patient conditions. Its primary purpose is to guarantee precise reimbursement and risk adjustment scores. Given the ever-changing healthcare landscape, it is imperative for healthcare providers and coding professionals to remain adaptable and well-informed about the evolving requirements. […]
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