The Rise of Hybrid Global Outsourcing Models in Healthcare

Given labor shortages and financial constraints, fully managed hybrid outsourcing solutions are increasingly gaining prominence. Hospitals and provider organizations grapple with staffing deficiencies across various departments, with the revenue cycle facing considerable strain. A recent survey among medical group leaders highlighted coders as the most challenging role to fill, closely followed by billers, schedulers, authorization […]
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Latest Changes in the CPT® Emergency Department Subsection

Attendees at AAPC’s AUDITCON, Nov. 3-4, 2022, came loaded with questions about the coding and guideline changes for evaluation and management (E/M) services in CPT® 2023. The conference offered several sessions on the subject, including the ED session, “Changes in 2023: Emergency Department,” presented by AAPC Chief Product Officer. The officer provided a high-level overview […]
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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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CMS Approves 10 New HCPCS Level II codes (Drug codes)

Ten new HCPCS Level II codes for drugs and biologicals will be payable for Medicare, effective for claims with dates of service on or after July 1, 2019. HCPCS Level II codes is a standardized coding system that is used primarily to identify products, supplies, and services not included in the CPT code set jurisdiction, such as […]
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CMS Announces HCPCS Coding, Coverage And Payment Initiatives To Improve Patient Access To New Technologies

On May 2, the Centers for Medicare and Medicaid Services (CMS or the Agency) announced in a press release that it will be changing how frequently the Agency reviews applications for new and revised Level II codes under the Healthcare Common Procedure Coding System (HCPCS). Specifically, CMS stated that the Agency “is moving to a process with […]
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The Facts Surrounding The Coding Chronic Kidney Disease - Allzone

The Facts Surrounding The Coding Chronic Kidney Disease

Complications of chronic kidney disease (CKD) include early death and heart disease. Chronic kidney disease (CKD) affects 15 percent of United States adults, or 37 million people, according to a recent statement by the Centers for Disease Control and Prevention (CDC).  The following are some basic facts about CKD; specifically, it is:   More common […]
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ICD-10 Coding Errors, Diagnostic Errors, Payment Reform. Coding Errors

New ICD-10 Codes will help Physicians Tackle Social Barriers to Care

A new collaboration between the AMA and UnitedHealthcare will work to address the social and environmental factors that affect patients’ health by standardizing data collection on their social determinants of health (SDOH) to help address individuals’ unique needs that often go unmet. The two organizations are supporting the creation of 23 new ICD-10 codes related […]
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CPT Codes

Six Tips to Getting Paid for CPT Modifiers

CPT modifiers help payers understand all of the distinct services and procedures physicians perform. As the scope of practice for today’s internists continues to expand, these modifiers are also increasingly required to ensure accurate payment, says Toni Elhoms, CCS, CRC, CPC, director of coding and compliance at RT Welter & Associates Inc., a healthcare consulting […]
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Medical Coding Services, ICD-10 Coding Services, CPT Coding Services

CPT 2020 and CPT 2021: Catch a Glimpse

A summary of the CPT® Editorial Panel’s actions during its February 2019 meeting offers us a glimpse of changes to come for the CPT 2020 and 2021. Perhaps the biggest news are approved revisions to office and outpatient E/M codes 99201-99215, scheduled for 2021 implementation, covered here. Other Approved Changes For 2021 Include: Significant revision to […]
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