Each year the American Hospital Association (AHA) releases an advocacy agenda focusing on key areas in need of “critical support” for hospitals and health systems, and this year, quite a few key areas will be focused on your revenue cycle. “Hospitals and health systems are dealing with unprecedented challenges as they manage the aftershocks and […]
February may be American Heart Month, but correctly diagnosing and coding cardiac conditions requires healthcare professionals to work hard to get right 365 days a year. Outlining coding guidance for pulmonary hypertension – a rare condition that nonetheless can be particularly deadly, often because it is not diagnosed until it is in advanced stages. It […]
Over 1,500 hospitals reviewed in the report were noncompliant with at least one requirement of the price transparency rule between December 2022 and January 2023. Less than a quarter of hospitals are complying with the hospital price transparency rule over two years after the regulation went into effect, according to a report from PatientRightsAdvocate.org. The […]
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 […]
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. […]
Don’t assume the codes you’ve been using to report drugs and biologicals still apply. The January 2023 update to the HCPCS Level II code file from the Centers for Medicare & Medicaid Services (CMS) includes 184 new codes for reporting services and supplies. Approximately 36 of the new codes were created to separately identify products […]
The omnibus spending bill continues telehealth waivers for two years past the PHE, but was silent on the issue of reimbursement. The federal government extended telehealth waivers for two years, but the current higher rate of reimbursement is in place only through the end of this year. During the public health emergency, the Centers for […]
Healthcare providers submitting claims for services, supplies, and accessories ordered under the Medicare Intravenous Immune Globulin (IVIG) Demonstration can expect to see an approximate 2.1 percent payment increase over last year. The calendar year 2023 rate for HCPCS Level II code Q2052 is $392.56, compared with $384.59 in 2022. What is the Medicare Intravenous Immune Globulin Demonstration? […]
Contrary to widespread hopes, the growth in telehealth brought on by the COVID-19 pandemic probably won’t lower health care costs. But it may make some services more widely accessible. A new Kaiser Family Foundation study compares average 2020 commercial insurance payments for evaluation and management and mental health therapy claims for services provided via […]
Outsourcing the medical billing process reshapes healthcare sectors by building better and more stable revenue cycle management systems and helps businesses in the long run. Additionally, outsourcing pulls down the operating costs and strengthens the efficiency of the revenue cycle parallelly. Outsourcing medical billing services to a reputable medical billing company brings about a range […]










