Tag: Allzone Management Services

Updates to the E&M Codes and Guidelines in 2023

Updates to the E&M Codes and Guidelines in 2023

The E&M categories that will undergo revision in 2023 encompass: Inpatient and observation care services. Consultations – both outpatient and inpatient Emergency department services Nursing facility services Home and residence services Prolonged services Throughout the upcoming months, a dedicated focus will be placed on each E&M category, delving into the revisions and changes in guidelines. […]
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Automating Revenue Cycle Operations Reduces Cost-to-Collect

Automating Revenue Cycle Operations Reduces Cost-to-Collect

Health systems that used automation for revenue cycle operations had an average cost-to-collect of 3.51 percent compared to 3.74 percent for those that did not use automation. Using automation for revenue cycle operations could lower hospital and health systems’ cost-to-collect by 0.25 percent, according to a survey from the Healthcare Financial Management Association (HFMA). The […]
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State Surprise Billing Laws Impact Out-of-Network Provider Charges

State Surprise Billing Laws Impact Out-of-Network Provider Charges

Provider charges for out-of-network care increased by $1,157 after the passage of state surprise billing laws that allow arbitrators to consider provider charges in a surprise billing dispute. State surprise billing laws that allow arbitrators to consider provider charges when determining out-of-network payment amounts for surprise medical bills led to an increase in billed charges […]
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Low Reimbursement Rates Lead to Rural Hospital Closures

Low Reimbursement Rates Lead to Rural Hospital Closures

Low reimbursement rates, staffing shortages, low patient volumes, and regulatory barriers are some of the root causes of rural hospital closures, the American Hospital Association (AHA) explains in a new report. The report “Rural Hospital Closures Threaten Access: Solutions to Preserve Care in Local Communities” highlights the variety of causes behind rural hospital closures, which […]
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Physician Practice Costs Grew 20% Per Claim

Physician Practice Costs Grew 20% Per Claim

Following a private equity acquisition, physician practices saw a 20.2 percent increase in charges per claim, an 11 percent raise in the allowed amount per claim, and a 37.9 percent increase in new patient visits. Private equity acquisition of physician practices in dermatology, gastroenterology, and ophthalmology was associated with increased healthcare spending and utilization, according […]
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Prior Authorization Reform in Medicare Advantage

Prior Authorization Reform in Medicare Advantage

Prior Authorization reform in Medicare Advantage would help relieve administrative burden for medical groups and reduce patient care delays, MGMA said. The Medical Group Management Association (MGMA) has urged CMS to implement policies that support prior authorization reform and value-based care contracts within the Medicare Advantage program. MGMA submitted comments to CMS Administrator in response […]
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23 New PLA Codes in Q3 of the CY 2022

23 New PLA Codes in Q3 of the CY 2022

A quarterly update to the Clinical Laboratory Fee Schedule (CLFS), issued by the Centers for Medicare & Medicaid Services (CMS) on Aug. 11, includes 23 new CPT® codes for proprietary laboratory analyses (PLA) tests. Medical coding and billing staff processing claims for lab testing should be aware of these code changes that are effective Oct. […]
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Updated Booster Codes for COVID-19 Vaccine Released

Updated Booster Codes for COVID-19 Vaccine Released

Age determines who qualifies for the bivalent formulations from Pfizer and Moderna. On Aug. 31, 2022, the U.S. Food and Drug Administration (FDA) amended the emergency use authorizations (EUAs) of the Moderna and Pfizer-BioNTech COVID-19 vaccines to include updated booster bivalent formulations. These latest formulations include messenger RNA components to help build immunity against both […]
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ICD-10 Codes for Work-Related Injuries 2022

ICD-10 Codes for Work-Related Injuries 2022

‘Good labors are the great resource for the company’ Here are the ICD-10 CM codes for general injuries in the workplace.   ICD-10-CM – Z77. 29: Exposure to Harmful Substances or Environments Z77.29 is a specific/billable code for Exposure to Harmful Substances that is used to indicate a diagnosis for reimbursement purposes. W22. 8XXA – Moving […]
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