Tag: Reimbursement

HCPCS Level II Code Updates for April 2024

HCPCS Level II Code Updates for April 2024

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 […]
Tips to Avoid Billing Errors in Radiology Practices

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 […]
Append Surgical Modifiers With Confidence

Append Surgical Modifiers With Confidence

Modifiers 79: Know how to differentiate modifiers 79, 78, and 58to ensure proper reimbursement for all procedures performed. Modifiers convey important information about a claim and can directly affect reimbursement. But choosing the most appropriate modifier can be confusing — especially when two or more modifiers have similar descriptors. Modifiers 58, 78, and 79 are all […]
Denials Management Versus Denials Avoidance_ CDI Can Capitalize

Denials Management Versus Denials Avoidance: CDI Can Capitalize

  Typical CDI programs are intended to drive reimbursement through diagnosis securement, contributing to improved case mix index. The COVID-19 pandemic is placing monumental financial stressors upon hospitals, with added costs to treat patients with high acuity and long length of stays, coupled with significant revenue loss associated with postponement of more profitable elective surgeries, […]
Transforming Revenue Cycle Management Using Automation

Transforming Revenue Cycle Management Using Automation

In today’s healthcare industry today, there is a lot of buzz and hype surrounding automation. Large healthcare networks, medical facilities, and revenue cycle management service providers alike are looking to achieve a more efficient, robust revenue cycle through automation technologies. Any technology that can free employees to focus on high-value tasks and make revenue cycle […]
COVID-19 Specimen Collection and Testing

COVID-19 Specimen Collection and Testing

How to code Medicare Part B claims for reimbursement. These past few months have been a whirlwind for everyone, but it’s fair to say medical coders have been hit with a category 5 hurricane. New codes and revised guidelines have been whirring about, making our heads spin. And now we have another new CPT® code […]
Two New CPT Codes Effective Immediately

News Alert: Two New CPT Codes Effective Immediately

Reimbursement details have not yet been established. The American Medical Association (AMA) CPT® Editorial Panel has made adjustments to one code and introduced two new codes to enhance the specificity of serology laboratory testing. These codes, released on April 10, are immediately applicable. Reimbursement arrangements for the Centers for Medicare & Medicaid Services (CMS) are […]
AI Can Help Health Plans Become Member-Centric

How AI Can Help Health Plans Become Member-Centric

Improving the customer experience is no longer an idea that’s relegated to the retail or hospitality industries. Now, the idea has gained traction across many industries, including healthcare. For health plans, improving the customer experience and providing member-centric care helps drive member acquisition and retention and improve reimbursement (via a better STARS rating). With so […]
3 Issues Revenue Cycle Leaders Will Have To Battle

3 Issues Revenue Cycle Leaders Will Have To Battle In 2020

First hand experiences from the country’s most innovative revenue cycles will be shared next month in West Palm Beach, Florida. What issues keep revenue cycle executives up at night? As the HealthLeaders’ revenue cycle editor, I will moderate discussions and hear firsthand experiences of successes, challenges, and the latest ideas coming out of the country’s most innovative […]