Tag: Reimbursement

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 […]
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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 […]
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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 […]
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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 […]
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Outpatient Proposals

2020 Outpatient Proposals: 5 Rules You Should Know From CMS

Hospital and health system executives should monitor these proposals for provisions that will affect their organizations’ operations. The 2020 annual rule cycle has been active for CMS. Several proposals in the outpatient prospective payment system (OPPS) proposed rule is controversial, although there is at least one provider-friendly change. Here’s a roundup of five regulatory rules […]
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Prevent Billing Errors to Reduce Hospice Claim Denials

Prevent Billing Errors to Reduce Hospice Claim Denials

Effective revenue cycle management can reduce hospice claim denials, particularly those associated with billing or documentation errors. In addition to slowing down payments or losing revenue, submitting inadequate or incomplete required written documentation is a sure-fire way to bring surveyors or auditors to a hospice’s doorstep. As regulators increasingly fix their eyes on the hospice space, providers […]
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CMS Releases FY 2020 ICD-10-PCS Codes Set

CMS Releases FY 2020 ICD-10-PCS Codes Set

CMS released the fiscal year (FY) 2020 ICD-10-PCS changes on Friday, May 31, which include two code revisions, 734 additions, and 2,056 invalidations. The files include information on ICD-10-PCS updates that all inpatient coders must use for discharges occurring from October 1, 2019, through September 30, 2020. The total number of ICD-10-PCS codes for 2019 was 78,881. […]
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Pain Management and The Global Period

Pain Management and The Global Period

Pain management during the global period of a procedure, if related to that procedure, is not separately reportable. If a provider other than the operating provider performs follow-up care, you must be careful to avoid “unbundling” of that follow-up care. The global period, or global surgical package, bundles all care typically related to surgical service into a […]
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HCPCS and CPT Codes

What’s New In 2019 For CMS

This year’s reporting for the Quality Payment Program will affect the 2021 payment year. Kevin J. Corcoran, COE, CPC, CPMA, FNAO, delivered his annual update at Hawaiian Eye 2019, highlighting changes CMS would be making this year for coding, payment issues, regulatory matters, administrative issues and reimbursement issues. The Medicare Physician Fee Schedule did not […]
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