Category: Blog

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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Important 2023 E&M Code Changes for Prolonged Services

Important 2023 E&M Code Changes for Prolonged Services

Among the changes are a new code for reporting prolonged services in the inpatient or observation setting and significant guideline revisions. The American Medical Association (AMA) recently announced major revisions to Evaluation and Management (E&M) Services, effective Jan. 1, 2023. The E&M categories that will undergo revision in 2023 include inpatient and observation care services, […]
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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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CMS Includes HCPCS Level II Code Changes

CMS Includes HCPCS Level II Code Changes

Dozens of additions, deletions, and revisions are effective Oct. 1, 2022. The October 2022 update to the HCPCS Level II code file from the Centers for Medicare & Medicaid Services (CMS) includes more than 40 changes, and most of them are new codes. The changes are effective Oct. 1, 2022, with a few important exceptions. […]
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3 Tools to Boost Engagement with Patients

3 Tools to Boost Engagement with Patients

Adopting the right technology can help allocate or reallocate time from physicians and staff to focus on patient engagement and satisfaction. With all the pressures on physician time these days, it’s no wonder some doctors struggle to engage patients fully in their medical care, overall health and future well-being. Patient engagement efforts compete with all […]
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