The focus on electronic health record implementation has turned to how to make use of the vast data stored within to improve revenue cycle operations (IRF). Proposed rule calls amending regulations clarifying the determination as to whether a physician qualifies as a rehabilitation physician is made by the IRF. The Centers for Medicare & Medicaid […]
The focus on electronic health record implementation has turned to how to make use of the vast data stored within to improve revenue cycle operations. “These EHRs capture so much data. The trick is translating that data into information,” said Cynthia Sikina, vice president of Financial Services with consulting firm Afia. The EHR is not providing […]
Suggestions for conducting peer-to-peer appeals for denials management. Claims Automation has been a part of the workers’ compensation and auto casualty industries for years, but today, a large opportunity still remains to increase in the claims automation process. The future of automation in the Property and Casualty industry is not to replace jobs but instead […]
The Centers for Medicare & Medicaid Services’ Patient-Driven Payment Model (PDPM) takes effect on Oct. 1. When the reform takes effect, long-term post-acute care (LTPAC) facilities will see a big change in how they receive payment for delivering valuable patient care. While the payment reform will inevitably bring challenges, it will also present a significant […]
Complications of chronic kidney disease (CKD) include early death and heart disease. Chronic kidney disease (CKD) affects 15 percent of United States adults, or 37 million people, according to a recent statement by the Centers for Disease Control and Prevention (CDC). The following are some basic facts about CKD; specifically, it is: More common […]
A new collaboration between the AMA and UnitedHealthcare will work to address the social and environmental factors that affect patients’ health by standardizing data collection on their social determinants of health (SDOH) to help address individuals’ unique needs that often go unmet. The two organizations are supporting the creation of 23 new ICD-10 codes related […]
GET OUT YOUR 2019 CPT® CODE BOOKS. YOU HAVE SOME CODE CHANGES TO MAKE. Effective July 1, 2019, the American Medical Association (AMA) is adding 21 new lab codes and deleting one in Appendix O, Multianalyte Assays with Algorithmic Analyses and Proprietary Laboratory Analyses. Deleted 0057U Oncology (solid organ neoplasia), mRNA, gene expression profiling by […]
CPT modifiers help payers understand all of the distinct services and procedures physicians perform. As the scope of practice for today’s internists continues to expand, these modifiers are also increasingly required to ensure accurate payment, says Toni Elhoms, CCS, CRC, CPC, director of coding and compliance at RT Welter & Associates Inc., a healthcare consulting […]
The new codes include drugs for migraines, to initiate blood-clotting in patients on certain coagulants, chronic and hairy cell leukemia, and folic acid for chemotherapy patients. The home health codes help facilitate the Centers for Medicare & Medicaid Services (CMS) Center for Medicare and Medicaid Innovation (CMMI) Pioneer ACO initiative. New HCPCS Level II Codes […]
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 […]