Category: Blog

Highly Anticipated 2023 Medicare Final Rules Published

Highly Anticipated 2023 Medicare Final Rules Published

The final rules become effective Jan. 1, 2023. Amid this election season, the Centers for Medicare & Medicaid Services (CMS) has published final rules for the 2023 Part B Physician Fee Schedule and Medicare Shared Savings Program, the Outpatient Prospective Payment (OPPS) and Ambulatory Surgical Center (ASC) Payment System, the End-Stage Renal Disease (ESRD) Prospective […]
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ICD-10-CM Codes for Diabetes Mellitus Symptoms

ICD-10-CM Codes for Diabetes Mellitus Symptoms

In 1991, International Diabetes Federation (IDF) & World Health Organization (WHO) combine to create World Diabetes Day (WDD) on November 14 and we take this day to spread awareness and education on Diabetes, a chronic disease where pancreas won’t produce enough insulin which leads to serious health issues. Many physician and health providers will struggle […]
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2023 MPFS and Quality Payment Program Final Rule Released

2023 MPFS and Quality Payment Program Final Rule Released

The conversion factor is down but certain public health emergency flexibilities will continue. The 2023 Medicare Physician Fee Schedule (MPFS) and Quality Payment Program final rule, released Nov. 1, allows Part B physician payment for behavioral healthcare, cancer screening, and dental care. But while the Centers for Medicare & Medicaid Services (CMS) continues its focus […]
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An EHR Vendor to Pay $45M to Resolve False Claims Act Allegations

An EHR Vendor to Pay $45M to Resolve False Claims Act Allegations

The U.S. Department of Justice alleges that the EHR vendor accepted and provided “unlawful remuneration in exchange for referrals and by causing its users to report inaccurate information in connection with claims for federal incentive payments.” A developer of electronic health record technology has agreed to pay $45 million to resolve allegations that it violated […]
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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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