Unlocking the Power of AI: Essential Features for Medical Coding and CDI Tools: When choosing an AI tool to improve medical coding or clinical documentation integrity (CDI), healthcare organizations navigate a complex landscape of emerging technologies. To ensure the right selection, focus on key features that enhance accuracy, efficiency, and compliance. One crucial aspect is […]
AI-driven coding automation can save your practice countless hours each week, allowing physicians and staff to focus on higher-value tasks. This innovative technology is set to revolutionize the coding process entirely. In the future, it’s likely the healthcare industry will look back and wonder, “How did we ever manage coding without AI?” Now, let’s dive […]
Modifier 50 is used to indicate that a procedure or service was performed on both sides of the body during the same operative session. It’s essential to use this modifier correctly to ensure accurate billing and reimbursement. Key points for appropriate use: Bilateral Procedures: The procedure must be performed on identical, opposing structures (e.g., eyes, […]
The Centers for Medicare & Medicaid Services (CMS) has announced updates to the Q4 HCPCS Level II code, effective October 1, 2024. These changes include: 58 new codes 10 codes with updated descriptions 6 discontinued codes Key Changes: New codes for medical and surgical supplies, outpatient procedures, durable medical equipment, and orthotic procedures. Replacement code […]
Discover the October HCPCS Level II Code Set Update: October 2024 HCPCS Level II code set will receive a quarterly update, introducing 32 new drug and biological codes. Additionally, five codes will be deleted, and five others will undergo revisions. Let’s explore what’s in store. New HCPCS Level II Codes The Centers for Medicare & […]
Defining the Challenge: Overcoming Obstacles in CDI and Coding: To clarify the overwhelming claims made by technology vendors, I’ve provided some basic definitions. As we embark on this journey, it’s crucial to pinpoint the specific obstacles we face. This will help us demonstrate to senior leadership and stakeholders the need for AI-driven solutions to enhance […]
The latest ICD-10-PCS codes and guidelines for the fiscal year 2024 have been unveiled by the Centers for Medicare & Medicaid Services (CMS). With a net growth of 73 codes, the total count of inpatient procedure codes has reached 78,603. Notably, the New Technology Section has experienced the largest surge, introducing 40 new codes. The […]
The Role of Medical Codes in Reimbursement Methodologies: Medical codes, such as CPT, HCPCS, and ICD-10 (CM and PCS), are essential components of various reimbursement methodologies. The Inpatient Prospective Payment System (IPPS), used by Medicare fee-for-service, categorizes patient stays into Medicare Severity Diagnosis Related Groups (MS-DRGs) based on ICD-10 codes processed through a computerized system. […]
The Centers for Medicare and Medicaid Services (CMS) has released a summary of each HCPCS Level II code application decision. The document is twenty-eight pages long and the link can be found in the Resources section. There are 23 items included in the HCPCS Level II Code Q2 2024 Drug and Biological decisions. Twenty new […]
H5N8 Avian Influenza Vaccine: The American Medical Association (AMA) has updated the Current Procedural Terminology (CPT) code set to include new codes for vaccines protecting against the H5N8 strain of avian influenza. This update follows a recent global outbreak of avian influenza, particularly the H5N1 strain, which has affected wild birds, poultry, dairy cows, and […]