Tag: medical-coding

Optimizing Revenue Cycle Management Automation

How AI in Optimizing Revenue Cycle Management Automation?

Healthcare Leaders believe that Artificial Intelligence (AI) and Automation have the capability to transform the revenue cycle management process the way we think. Only a robust and durable revenue cycle automation solution is needed to handle all complexities involved in patient eligibility verification to the denial management process. Healthcare provider needs several key steps to […]
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Billing for Tetanus Vaccine? Check the Diagnosis

Did you know that tetanus vaccines are only covered under Medicare Part B when given for treatment? Preventative tetanus vaccinations are non-covered. Sure enough, the Centers for Medicare & Medicaid Services Internet-Only Manuals Pub. 100-02, Chapter 15, Section states, “Vaccinations or inoculations are excluded as immunizations unless they are directly related to the treatment […]
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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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Coding Drives Up Medical Billing Costs in US

Another study confirms that medical billing costs in the US significantly exceed those in similar countries, but researchers now know why: coding drives up US administrative spending. Complex coding structures in the US are driving up medical billing costs in the US, making it one of the most expensive countries to get paid, according to […]
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AMA Finalizes CPT Codes for Third Doses of Moderna, Pfizer Vaccines

AMA announced that the CPT codes for the third doses of the Moderna and Pfizer COVID-19 vaccines are finalized and ready for the upcoming booster shot administrations. The American Medical Association (AMA) announced that the Current Procedural Terminology (CPT) codes for the third doses of the Moderna and Pfizer COVID-19 vaccines are effective for immediate […]
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CMS Seeks to Improve Healthcare Outcomes and Drive Down Costs

CMS’ proposed actions are intended to increase price transparency, access to care, patient safety, positive healthcare outcomes, and health equity. On July 19, 2021, the Centers for Medicare & Medicaid Services (CMS) announced new proposed actions to address the health equity gap, decrease mounting healthcare costs, and increase medical accessibility and patient quality of care. […]
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2022 ICD-10-CM Guidelines Released

Released earlier than usual, the fiscal year (FY) 2022 ICD-10-CM Official Guidelines for Coding and Reporting became available online Monday, July 12, and include instructions for assigning novel code U09.9 Post COVID-19 condition (found under Section I.C.1.g.1). Familiarize yourself with the following new and revised guidance, effective October 1, to ensure proper diagnosis coding and […]
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Get a Peek at Future ICD-10 Codes

An ICD-10 Coordination and Maintenance Committee virtual meeting is scheduled for March 9–10, from 9 a.m. to 5 p.m. The Centers for Medicare & Medicaid Services (CMS) and the Centers for Disease Control and Prevention National Center for Health Statistics (CDC NCHS) have posted tentative agendas on their websites. Stakeholders will present on a variety […]
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