Tag: medical-coding

Medical Coding Services, ICD-10 Coding Services, CPT Coding Services

CPT 2020 and CPT 2021: Catch a Glimpse

A summary of the CPT® Editorial Panel’s actions during its February 2019 meeting offers us a glimpse of changes to come for the CPT 2020 and 2021. Perhaps the biggest news are approved revisions to office and outpatient E/M codes 99201-99215, scheduled for 2021 implementation, covered here. Other Approved Changes For 2021 Include: Significant revision to […]
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2019 Codes Subject To Or Excluded From CLIA Edits

The CPT® codes that are considered a laboratory test under the Clinical Laboratory Improvement Amendments (CLIA) change each year, as well as throughout the year, making it difficult for healthcare providers and laboratories to keep up. Here are the CPT codes for 2019 that are subject to or excluded from CLIA edits in easy-to-look up […]
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Rewriting of Medical Coding Automation Using Artificial Intelligence

The importance of Artificial Intelligence (AI) in Medical Coding is often understated and also overstating the same is quite difficult.. to get in-depth with how AI is actually bringing changes in MCA, we must get to the basics of what Medical Billing and Coding really are. Medical Coding Medical coding, if we talk about it […]
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Mastering Revenue Cycle Management

Doctors are fond of complaining that they didn’t go to medical school in order to practice business, but independent physicians do spend much of their time on their practices’ finances. That requires mastering revenue cycle management (RCM), the financial process practices use to administer all the functions associated with claims processing, payment, and revenue generation. […]
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New Rules Issued for Modifiers 59, XE, XS, XP, and XU

The Centers for Medicare & Medicaid Services (CMS) issued a policy change modification to the claims processing logic for Modifier 59 Distinct procedural service (and the optional patient-relationship modifiers XE, XS, XP, and XU) on February 15, 2019. These modifiers are only processed when applied to the Column 2 code in a bundled pair, per Correct Coding Initiative […]
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5 Ways to Ensure RCM Efforts Don’t Leave Money on the Table

A frequent knock on electronic health records has been that they’re just glorified billing systems that fail to provide enough clinical functionality to make a significant difference in quality of care. So it’s somewhat incongruous that a recent Black Book report on revenue cycle management (RCM) system adoption would say that 26 percent of hospitals […]
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How Cryptocurrency Benefits Medical Billing Services

Cryptocurrency benefits medical billing services, and in turn healthcare staff and patients, in so many ways. Here’s what to know A cryptocurrency is a decentralized virtual or digital currency that’s used as a medium of exchange for using particular products/services. It is like normal currencies but it also facilitates the exchange of digital information. Counterfeiting cryptocurrency is difficult […]
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Medicare Advantage Plans and the Two-Midnight Rule

Controversy continues to swirl around this subject. A recent article of mine focused on the argument that Medicare Advantage (MA) plans have to follow the two-midnight rule. It certainly generated buzz; I received a number of emails with comments and questions. First, I want to note that I love getting comments and questions. I can’t […]
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“Defensive” Undercoding Is Indefensible

Undercoding, or reporting a lesser service than was performed and documented, is sometimes employed as a defensive strategy to stave off claims denials or audits. But, undercoding can make a provider an outlier, and may create consequential patient care, compliance, and financial liabilities. For example: Undercoding Leaves Money On The Table, Driving Down Provider Reimbursement […]
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3 Key Strategies to Increase Healthcare Revenue Cycle Efficiency

As providers engage in complex payment models and collect more from patients, they must learn to automate key functions to improve healthcare revenue efficiency. The healthcare revenue cycle has many moving parts. From patient access and registration to medical billing and coding, provider organizations of all sizes must achieve revenue cycle efficiency to ensure providers […]
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