Hospitalists play a crucial role in patient care, especially in inpatient settings. Using specific medical codes is essential for accurate coding and billing hospitalist services to ensure proper reimbursement. Hospitalists often deal with complex medical conditions...
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How to Code for Hypertensive Heart Disease
Hypertensive Heart Disease (HHD) refers to damage inflicted on the heart as a result of prolonged high blood pressure (hypertension). It is one of the leading causes of illness and death associated...
Medical Billing for Behavioral Health Services – Challenges and Solutions
Recent changes to both diagnostic and procedure codes as well as variability in requirements across private and public insurers pose many challenges for behavioral health medical billing: ICD-10-CM...
Physician Practice Setting can Improve Reimbursement for Respiratory Therapists
Pulmonary rehabilitation is a multidisciplinary program meant for patients with chronic respiratory conditions, especially for those with chronic obstructive pulmonary disease (COPD). Physicians...
Coding Post-operative Complications with ICD-10
Postoperative complications significantly contribute to patient morbidity and mortality, prolonged hospital stays, and increased healthcare costs. These complications can be general or specific to...
Medical Specialties with Complex Coding Challenges under ICD-10
Now that ICD-10-CM implementation is well on its way, it is evident as to how various specialties have been affected by the changes. Providers can ensure appropriate reimbursement only by...
Coding ‘Episode of Care’ – The 7th Character in ICD-10-CM
There are several differences between the format of ICD-9 and ICD-10 coding and this has brought about new medical billing and coding challenges. One of these is the need to assign the 7th character...
“Pokemon Go” Injuries – Code it with ICD-10
Can a virtual-reality game played on mobile phone really cause physical injuries? Yes, “Pokemon Go” can. The craze for the game is resulting in more and more accidents. Using Google Maps, it creates...
Clarifications on Reporting Non-urgent Services in the Emergency Department
Emergency department (ED) visits identified by CPT code 99285 require three key components: comprehensive history, comprehensive examination, and medical decision making of moderate complexity....
Challenges of Coding for Immunizations
Billing for vaccine administration is challenging and explains why many providers choose medical billing and coding outsourcing. There are different codes for Medicare and private insurance...
RADV Audit Services for Compliance with CMS Contract Requirements
The Centers for Medicare and Medicaid (CMS) conduct Risk Adjustment Data Validation (RADV) audits to recover improper payments under Medicare Part C or Medicare Advantage (MA) plans. In risk...