Tag: medical-coding


Should ICD-10-CM Feature Codes for Every Genetic Condition?

It may become common practice to identify genetic abnormalities prior to the development of manifestations. The March 2023 ICD-10-CM Coordination and Maintenance Committee Meeting presented me with a dilemma (Topic packet March 8, 2023, ICD-10-CM Coord & Maint Cmte Meeting). Now that we have the technology to unravel the genetic basis for conditions, are we […]
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Significance of Medical Coding Strategies

Medical coding strategies contribute various benefits, counting cost reduction and control, systematic healthcare management, and increased scalability. Compliance with medical coding qualities also promises patients’ data privacy and security and alleviates the threats of audits. In the current healthcare landscape, keeping up financial solidity has become progressively hard due to the shift from fee-for-service to […]
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E/M Payment Policy Changes Impact Physician Reimbursement

Following E/M payment policy changes, the reimbursement gap between primary care and specialty physicians decreased by just $825, falling from $40,259.80 to $39,434.70. Evaluation and management (E/M) payment policy changes implemented in 2021 resulted in higher Medicare reimbursement for most physicians but only led to a modest decrease in the payment gap between primary care […]
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How Does Medical Billing and Coding Increase Cash Flow?

Error-free medical billing and coding are critical characteristics of a revamped revenue cycle system. Appropriate billing and coding are not only needed in terms of compliance but are also pivotal in bringing down medical claim denials and rejections. When you take a more dynamic approach to your billing and coding operation, you not only get […]
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Coding of Cardiac Conditions Takes The Center Stage

February may be American Heart Month, but correctly diagnosing and coding cardiac conditions requires healthcare professionals to work hard to get right 365 days a year. Outlining coding guidance for pulmonary hypertension – a rare condition that nonetheless can be particularly deadly, often because it is not diagnosed until it is in advanced stages. It […]
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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 covered under Medicare Part B only when administered for treatment purposes? Preventive tetanus vaccinations do not fall under coverage. The Centers for Medicare & Medicaid Services Internet-Only Manuals Pub. 100-02, Chapter 15, Section clarifies, “Vaccinations or inoculations are excluded as immunizations unless they are directly related to […]
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2023 CPT Code Set, Aims to Reduce E/M Coding Burden

The 2023 CPT code set will update the rest of the E/M code section after significant changes in 2021, as well as revise AI and virtual care codes. The American Medical Association (AMA) has released the Current Procedural Terminology (CPT) code set for 2023, which contains updates that aim to reduce medical coding burden for […]
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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 the US

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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