Healthcare providers and patients often report difficulties with health insurers regarding prior authorizations, with many consumers saying their care was either denied or delayed last year, due to the requirements in pre-authorizations. Keeping the existing concerns...
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Medical Coding and Billing for Advance Care Planning
According to the Population Reference Bureau, the number of Americans ages 65 and older would more than double from 46 million in 2016 to over 98 million by 2060, and the share of the 65 plus age...
Hernia Repair – Code it Right to Maximize Reimbursement
A hernia occurs when an organ or tissue pushes through a weakened area in the surrounding muscle or connective tissue (fascia). This abnormal protrusion can involve an empty sac or, if the defect is...
How to Document Correctly to Support Physical Therapy Evaluation Code Selection
Starting 2017, physical therapy medical coding involves three new evaluation codes and a new reevaluation code. The evaluation codes introduced by the final CMS physician fee schedule replace code...
Documenting Tonsillitis with Specific ICD-10 Medical Codes
Tonsillitis is inflammation of the tonsils most commonly caused by a viral or bacterial infection. Health professionals who treat this condition include pediatrician, family medicine physician,...
Steer Clear of Audit Risks with Proper E/M Documentation
Many physicians outsource revenue cycle management to medical billing companies to enhance cash flow and reduce costs. However, accurate documentation of the patient encounter is necessary to...
Influenza Vaccine Coding in 2017 – Key Points to Note
The goal of immunization providers is to ensure that vaccines reach all people who need them. Accurate vaccine coding increases opportunities for enhanced/appropriate reimbursement, reduces audit...
Veteran Health Care in 2017 – Key Possibilities and Predictions
Legislation passed in 2014 allowed military veterans with access to physicians outside Veteran Administration (VA) facilities, including community based family practitioners. Family physicians who...
New 2017 Moderate Sedation CPT Codes to Impact Reimbursement across Multiple Specialties
CPT coding changes for moderate sedation (MS) in 2017 will impact reimbursement across various specialties. Outsourced medical billing companies are prepared for these changes that have created new...
ICD-10 Glitch – What Physicians Should Know
Physician coding companies played a key role in helping healthcare providers across the nation transition to ICD-10. Now recent reports say that there is a glitch in ICD-10, which CMS points out...
Top Challenges Physicians Could Face in 2017
Medical billing and coding changes happen every year. With the change in U.S. presidency from Barack Obama to Donald Trump, big changes are expected in the healthcare industry this year. According...