Tag: Accurate Coding

medical coding in value-based care

Medical Coding in Value-Based Care: Accuracy for Success

The healthcare landscape is undergoing a significant transformation, shifting from a fee-for-service model to value-based care (VBC). This patient-centric approach emphasizes quality of care, patient outcomes, and cost-effectiveness. For healthcare providers to thrive in this evolving environment, optimizing revenue cycle management is paramount, and at the heart of this lies efficient and accurate medical coding […]
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ICD-10 Codes for New Year: Holiday-Related Injuries

ICD-10 Codes for New Year: Holiday-Related Injuries

The arrival of the New Year brings excitement as people worldwide gear up to welcome 2025 with dazzling celebrations. For many, it’s a time for fireworks, dancing, and toasting to new beginnings. However, for healthcare providers, understanding the relevant ICD-10 codes for New Year is crucial, as treating patients remains uninterrupted, even during the holiday […]
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Mastering Historical Medical Code Sets for Audits, Appeals, and Research

Mastering Historical Medical Code Sets for Audits, Appeals, and Research

Remaining up-to-date is essential in the healthcare industry, but relying solely on current codes isn’t always the best approach. When auditing, handling appeals, or researching code usage for past encounters, a solid grasp of the descriptors and guidelines applicable during the date of service (DOS) can profoundly impact outcomes. Here’s a concise guide on effectively […]
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Common coding mistakes and how AI is resolving them

How Medical Coding Mistakes Cost You Money

The administrative burden of accurate medical coding is a major contributor to physician burnout—a challenge exacerbated by the COVID-19 pandemic. Studies consistently rank coding-related stress as one of the top concerns for healthcare providers. Medical Coding Mistakes, whether due to oversight or complexity, can have severe financial repercussions for medical practices. Denied claims, reduced reimbursements, […]
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Six Tips to Getting Paid for CPT Modifiers

Six Tips to Getting Paid for CPT Modifiers

In medical coding, CPT modifier are vital for accurate reimbursement of healthcare services. These special codes, attached to primary procedure codes, provide additional details about the complexity or extent of a service. However, using modifiers incorrectly can lead to claim denials and lost revenue. This blog post shares six key tips to help you get […]
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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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