Category: Medical Coding

Comparing 2023 CPT E_M with Documentation Guidelines

Comparing 2023 CPT® E/M with Documentation Guidelines

The 1995 and 1997 Documentation Guidelines and the 2023 CPT® E/M Services Guidelines are not drastically different when compared side by side. Some hospitals and coding and billing entities may believe that the new 2023 CPT® evaluation and management (E/M) services guidelines and code changes simplify the coding, billing, and auditing processes. However, it is […]
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New Coding Requirements Result in Reduced EHR Documentation Time for Doctors

New Coding Requirements Result in Reduced EHR Documentation Time for Doctors

According to a research letter published in top journal, the attempt by Centers for Medicare & Medicaid Services (CMS) to alleviate the EHR documentation burden on physicians has not yielded the anticipated outcomes. At the beginning of 2021, Centers for Medicare & Medicaid Services (CMS) revised the evaluation and management (E/M) coding requirements for outpatient […]
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How Automated Medical Coding Benefits Healthcare Sectors?

How Automated Medical Coding Benefits Healthcare Sectors?

The relationship between medical coding and patient care may not initially appear connected, and they may even seem like complete opposites. While medical coding focuses on billing and revenue, patient care revolves around providing care to individuals. An from leading E-magazine’s recent article  emphasized this distinction, asserting that prioritizing care is essential over coding. However, […]
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Guide to the Latest HCPCS Level II Codes

Guide to the Latest HCPCS Level II Codes

A retroactive effective date of April 1 has been assigned to a newly introduced code. The Centers for Medicare & Medicaid Services (CMS) has released the results of its review cycle for drug and biological HCPCS Level II codes in the first quarter of 2023. Out of the 36 applications received, 23 have been approved […]
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Top 4 Compliance Policies and Procedures You Need to Know

Top 4 Compliance Policies and Procedures You Need to Know

Your healthcare entity is at risk if these elements aren’t part of its compliance plan. As healthcare workers, it’s our responsibility to know and understand that the Office of Inspector General (OIG) expects all healthcare entities to follow and abide by its self-proclaimed seven elements of an effective compliance program. The first element, implementing written […]
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CMS Rules for Coding Emergency Department Claims | Best Practices

CMS Rules for Coding Emergency Department Claims | Best Practices

The Centers for Medicare and Medicaid Services (CMS) has consistently authorized hospitals to establish and utilize their own coding guidelines for emergency department facility claims. CMS makes clear that “[a]s long as the services furnished are documented and medically necessary and the facility is following its own system, which reasonably relates the intensity of hospital […]
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Mastering Medical Coding: Strategies To Avoid Revenue Loss

Mastering Medical Coding: Strategies To Avoid Revenue Loss

Medical coding is an essential aspect of healthcare in that it translates diagnoses, procedures, medical services, and equipment into alphanumeric codes. The processes involved in medical coding is complex, however, so errors can often result in payment delays and significant financial losses. The most common errors leading to delays and lost revenue are tracking down […]
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