Physicians will soon start having an easier time — and perhaps get paid more money — when they code for evaluation and management (E/M) services, thanks to the American Medical Association (AMA). The first major changes to the definitions for E/M services will be in effect as of January 1, 2021, with all payers expected […]
The mood of the country impacts claims. There are a few words that can be associated with the pandemic and the election. These words are the following: Stress – a state of mental or emotional strain or tension resulting from adverse or very demanding circumstances Anxiety – a feeling of worry, nervousness, or unease typically […]
Dive Brief: In the first two years diagnostic codes specific to social determinants of health were available in Medicare fee-for-service claims, they were used for only 1.4% of the total beneficiary population, according to a new report from CMS. Use of the Z codes, first implemented for Medicare FFS in 2016, increased slightly from that […]
Guidance for using out-of-office BPs is not new. Medical evidence and clinical guidelines published over the last decade have showcased the importance of 24-hour ambulatory monitoring as the reference standard, and self-measured blood pressure monitoring (SMBP) as an acceptable alternative for obtaining BPs to diagnose and treat hypertension. And thanks to that abundance of research […]
How many times has a provider asked you, “What do I need to document to get a 99215?” All too often, medical coders feel they should help their providers understand what elements of documentation are needed to warrant the higher level evaluation and management (E/M) service. Do not do it! If It Isn’t Documented, It […]
The FY 2020 Inpatient Prospective Payment System (IPPS) proposed changes could bode well for many facilities. There has been much discussion about the Centers for Medicare and Medicaid (CMS) Inpatient Prospective Payment System (IPPS) for fiscal year (FY) 2020 proposed rule and its suggested changes. Good news can be found in the 1,824 pages of […]
In October 2015, physicians across the United States transitioned from the International Statistical Classification of Diseases and Related Health Problems, Ninth Revision to the tenth revision (ICD-10-CM, the US version of the World Health Organization [WHO] ICD-10). Although the ICD-10-CM was a new concept for physicians in the United States, the international variant has been available since […]