Category: Blog

CPT® and HCPCS Newly Added and Revised Codes

CPT® and HCPCS Newly Added and Revised Codes

CPT® codes are effective Jan. 1, 2023. The American Medical Association (AMA) released CPT 2023 on Sept. 12. There are 225 new codes, 75 deletions, and 93 revisions. Most of the changes fall in the Evaluation and Management (E&M) section. The 2023 CPT codes are effective Jan. 1, 2023. The October 2022 release of the […]
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Reasons for Holdups in the Medical Billing Process

Reasons for Holdups in the Medical Billing Process

The revenue cycle process within healthcare is intricate and has led to disconnections among various stakeholders, including physicians, coding teams, billers, and administrators. This has resulted in the diversion of time and staff resources away from patient care towards revenue collection efforts. This situation leads to lost revenue, diluted patient care quality, and decreased staff […]
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Is Medicare Advantage Really a Disadvantage?

Is Medicare Advantage Really a Disadvantage?

It’s autumn, and along with leaves changing color, pumpkin spice lattes, and cooler weather comes an avalanche of TV ads, commercials, and telephone marketing calls, all entreating us to believe that Medicare Advantage (MA) is the best thing since the invention of the cell phone. With open enrolment season upon us, it’s critical to examine […]
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Billing for Tetanus Vaccine? Check the Diagnosis

Billing for Tetanus Vaccine? Check the Diagnosis

Did you know that tetanus vaccines are covered under Medicare Part B only when administered for treatment purposes? Preventive tetanus vaccinations do not fall under coverage. The Centers for Medicare & Medicaid Services Internet-Only Manuals Pub. 100-02, Chapter 15, Section 50.4.4.2 clarifies, “Vaccinations or inoculations are excluded as immunizations unless they are directly related to […]
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CPT Code Set Released for the year 2023

CPT Code Set Released for the year 2023

The American Medical Association (AMA) says the 2023 CPT code updates emphasize its efforts to reduce administrative tasks. The AMA released the calendar year 2023 CPT code set, which builds on the AMA’s efforts to reduce administrative tasks in medicine, according to a recent press release. The CPT code update contains 393 changes, including 225 […]
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No Surprises Act dispute resolution challenge

No Surprises Act dispute resolution challenge

The AHA and American Medical Association yesterday filed a friend-of-the-court brief in support of a Texas Medical Association lawsuit claiming the revised independent dispute resolution process for determining payment for out-of-network services under the No Surprises Act skews the arbitration results in commercial insurers’ favor in ways that violate the compromise Congress reached in the […]
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Hospitals Increased Recruitment and Retention Strategies

Hospitals Increased Recruitment and Retention Strategies

Hospitals are ramping up recruitment and retention strategies as they navigate ongoing workforce shortages and rising expenses. A majority of hospital leaders have increased starting salaries and introduced signing bonuses to attract new employees. The 2022 Healthcare Performance Improvement Report, based on responses from 86 hospital and health system leaders across the U.S., highlights the […]
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PBMs tend to Dominate State and Local Markets

PBMs tend to Dominate State and Local Markets

Pharmacy benefit managers (PBMs) tend to dominate state and local markets where they provide services to commercial health insurers across the United States. That could mean patients are stuck with higher prescription drug prices, according to new research published by the American Medical Association (AMA). The Policy Research Perspective report, “Competition in Commercial PBM Markets […]
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