Tag: Reimbursement

2024 ICD-10-CM Code

ICD-10-CM Code Changes: What You Need to Know

The healthcare industry is no stranger to constant updates, especially when it comes to coding and billing. As medical knowledge advances, disease trends change, and the healthcare landscape evolves, the Centers for Medicare & Medicaid Services (CMS) and the National Center for Health Statistics (NCHS) update the 2024 ICD-10-CM Code set every year Healthcare providers, […]
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2024 Medical Coding Updates

2024 Coding Updates: Navigating New CPT, HCPCS, and ICD-11 Changes

In 2024, healthcare providers, medical coders, and revenue cycle management (RCM) professionals need to stay up-to-date on 2024 medical coding updates. Several updates have been made to Current Procedural Terminology (CPT), Healthcare Common Procedure Coding System (HCPCS), and International Classification of Diseases (ICD-11) by the American Medical Association (AMA), the Centers for Medicare & Medicaid […]
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ICD-11 Transition Guide

Navigating the Shift: Preparing for the ICD-11 Transition in 2024

The healthcare industry is on the verge of a significant transformation as we approach 2024: transitioning from ICD-10 to ICD-11. Healthcare providers, payers, and patients alike will all be impacted by this shift, which promises to revolutionize the way medical diagnoses and treatments are documented and reported. Our comprehensive guide explores the intricacies of ICD-11, […]
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compliant coding and billing

Compliant Coding and Billing for Physicians: Expert Tips

The article explores common billing mistakes and offers tips for four healthcare services that can cause payment headaches for physicians. 1. Annual Wellness Visits vs. Physicals: Understanding Medicare Requirements Differentiating between Annual Wellness Visits (AWV) and Initial Preventive Physical Exams (IPPE) is crucial for accurate billing. Both are covered by Medicare for preventive care, but […]
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CPT Modifier

Six Tips to Getting Paid for CPT Modifiers

In medical coding, CPT modifier are vital for accurate reimbursement of healthcare services. These special codes, attached to primary procedure codes, provide additional details about the complexity or extent of a service. However, using modifiers incorrectly can lead to claim denials and lost revenue. This blog post shares six key tips to help you get […]
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modifier 58 vs modifier 78

Modifier 58 Versus 78 – Which Should You Use?

Modifier 58 vs Modifier 78: Key Takeaway: Modifier 58: Same underlying condition, planned or unplanned additional procedure. Modifier 78: New problem caused by the initial surgery (complication) requiring a return to the OR. Medical Coders often struggle to differentiate between modifier 58 (staged/related procedure) and modifier 78 (unplanned return to OR). Let’s break down the […]
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April 2024 HCPCS Level II Code

April 2024 HCPCS Level II Code Update

The official April 2024 update to the HCPCS Level II code set is now available on the Centers for Medicare & Medicaid Services website.  April update includes: 62 new codes 2 changes to scope and long description 21 obsolete codes 11 changes to long description 1 change to changes miscellaneous changes Below are some  code […]
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Tips to Avoid Billing Errors in Radiology Practices

Have you ever received a medical bill that left you perplexed, questioning how the expenses added up and left you scratching your head? If that’s the case, you’re certainly not alone. Billing for radiology can be intricate and confusing, involving numerous codes and procedures. Unfortunately, errors in medical billing are all too frequent, resulting in […]
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