Category: Blog

The Risks and Benefits of AI in Healthcare

The Risks and Benefits of AI in Healthcare

The hype around Artificial Intelligence (AI) spiked again recently with the public release of ChatGPT. The easy-to-use interface of this natural language chat model makes this AI particularly accessible to the public, allowing people to experience first-hand the potential of AI. This experience has spurred users’ imagination and generated feelings ranging from great excitement to […]
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CMS Corrects Time Thresholds for Prolonged Services

CMS Corrects Time Thresholds for Prolonged Services

What a difference 15 minutes can make when billing E/M services. The Centers for Medicare & Medicaid Services (CMS) issued a notice March 14 correcting several errors in the 2023 Medicare Physician Fee Schedule (MPFS) final rule. Most notably, CMS is correcting technical errors in the calculations of the time thresholds for reporting evaluation and […]
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E/M Payment Policy Changes Impact Physician Reimbursement

E/M Payment Policy Changes Impact Physician Reimbursement

Following E/M payment policy changes, the reimbursement gap between primary care and specialty physicians decreased by just $825, falling from $40,259.80 to $39,434.70. Evaluation and management (E/M) payment policy changes implemented in 2021 resulted in higher Medicare reimbursement for most physicians but only led to a modest decrease in the payment gap between primary care […]
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Five Tips For Physicians To Maximize Data Security

Five Tips For Physicians To Maximize Data Security

Digital transformation is expanding the cyber attack surface in health care and other sectors. Today, threat actors are working overtime to exploit vulnerabilities in health care systems, its primary care physicians and their applications, resulting in data breaches that expose confidential and protected information. The Health Insurance Portability and Accountability Act of 1996 (HIPAA) is […]
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Six Steps to Prevent Readmission Denials

Reducing Readmission Denials Through Strong Documentation Practices

Preventing readmission denials strengthens the Case Mix Index (CMI), improves reimbursement, and enhances quality performance metrics. Healthcare organizations can significantly reduce denial risk by ensuring accurate clinical documentation, appropriate discharge planning, and comprehensive patient follow-up. Evaluating Readmissions for Potential Denials Healthcare organizations frequently review 30-day readmissions to determine whether actions taken—or not taken—during the initial […]
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Important Changes to ICD-10-CM Codes and Guidelines

Important Changes to ICD-10-CM Codes and Guidelines

The updates to ICD-10-CM and ICD-10-PCS that become effective April 1 were released in mid-January. The updates include 42 new diagnosis codes. The significant changes to the ICD-10-CM guidelines are the following: A.19 – Code Assignment and Clinical Criteria This section has added a new sentence: “If there is conflicting medical record documentation, query the […]
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Six Common Medical Coding Mistakes Physicians Make

Not Coding the Highest Level When it comes to ICD-10 coding, a coder’s job is to code to the highest level of specificity. This means detailing and abstracting the most information out of the medical reports from the provider and taking accurate notes. It also means knowing the medical terminology for both procedures and diagnoses. […]
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The 2023 Telehealth Service Codes Physicians Need to Know

The 2023 Telehealth Service Codes Physicians Need to Know

Question: Could you kindly provide us with the updated telehealth services codes for the year 2023? Response: Regarding Medicare Telehealth Services for the year 2023, the Centers for Medicare and Medicaid Services (CMS) are introducing fresh Healthcare Common Procedure Coding System (HCPCS) codes to the compilation of Medicare telehealth services. More precisely, the subsequent HCPCS […]
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Latest Guidelines for Medical Coding E/M services in 2023

Latest Guidelines for Medical Coding E/M services in 2023

A thorough understanding of the latest guidelines for coding evaluation and management services is necessary to ensure compliant claims. You’ve likely heard about the 2023 CPT® changes for reporting hospital inpatient and observation evaluation and management (E/M) services. AAPC has been preparing medical coders for these changes since they were announced and started offering education […]
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