Category: Blog

CMS Proposes Changes to Physician Fee Schedule, Quality Payment Program

CMS Proposes Changes to Physician Fee Schedule, Quality Payment Program

The Centers for Medicare & Medicaid Services (CMS) is proposing changes to the Medicare Physician Fee Schedule (PFS) and the Quality Payment Program as part of its effort to reduce provider burden. “Clinicians are drowning in paperwork and reporting requirements caused by cumbersome government rules and regulations,” said CMS Administrator Seema Verma in a press […]
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Global Surgery & Related Service

Procedural Codes: Global Surgery & Related Services

Multiple Surgeries Multiple surgeries are separate procedures performed by a physician on the same patient at the same operative session or on the same day. Multiple surgeries are distinguished from procedures that are components of or incidental to a primary procedure. Intraoperative services, incidental surgeries or components of surgeries will not be separately reimbursed. Reimbursement […]
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Hundreds of New ICD-10-CM Codes

Hundreds of New ICD-10-CM Codes Effective Oct. 1

The Centers for Medicare & Medicaid Services (CMS) released on June 20 the new ICD-10-CM codes descriptions, tables and index, and addendum for fiscal year 2020. There are 273 additions, 21 deletions, and 30 revisions, effective Oct. 1, 2019, which will increase the code set from 71,932 to 72,184 diagnoses. Chapter Review The majority of changes to new […]
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Using Artificial Intelligence To Advance Revenue Cycle Management

Using Artificial Intelligence To Advance Revenue Cycle Management

Artificial intelligence (AI) is making big waves in healthcare from detecting lung cancer and gene mutations that lead to autism to addressing social determinants of health and chronic conditions. The technology is automating and optimizing clinical workflows, leading to improved outcomes, lower costs, and enhanced patient and provider satisfaction. The critical role artificial intelligence now plays in healthcare prompting some providers to […]
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Blockchain Takes Over The Power to Heal

Blockchain Takes Over The Power to Heal

Blockchain has taken the shape of an important asset in the 21st century with applications starting from practitioner’s authentication to supply chain management. The abilities of the robust privacy and interoperability of blockchain can change the healthcare space and improve the wide range of needs in healthcare. Blockchain provides a reliable and standard chain of […]
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Medicare Advantage Plan Denials

Medicare Advantage Plan Denials: Is That Convoluted or What?

Medicare Advantage Plan contracts are “take-it-or-leave-it” agreements Many questions are swirling about regarding Medicare Advantage Plan (MAP) denials asking what to do about the increasing number and given reasons.  I’ve heard or read some amazing stories where payers have gone to astounding lengths to deny claims.  Answers are also swirling about based on understandings of […]
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Correct Common OB/GYN Coding Mistakes

Overlooking separately billable services rendered during the global period will cost your practice dearly. Many obstetrics/gynecology (OB/GYN Coding) practices are coding deliveries incorrectly or failing to submit claims for “problem visits” during a prenatal or postpartum visit. Common mistakes such as these not only fail to capture payment for services rendered but also the meaningful […]
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