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Stories
Are you in confusion over COVID-19 coding and claim requirements?
According to a new survey that confusion over COVID-19 medical coding and insurance claim requirements is one of the top effects the pandemic has had on revenue cycle management in the healthcare industry.
Impact of Pandemic on Value-Based Contracts
Value-based contracts are usually relying on historical data for starting claim targets, trend rates, and/or quality measures. Current alterations from COVID-19 can disturbing upcoming contract periods for the next one to three years. Additionally, existing risk adjustment models may not appropriately account for COVID-19 pandemic impacts.
Extension of Prior Authorization for Repetitive Scheduled Non-Emergent Ambulance Transports
Federal Register announced in their notice that a 1-year extension of the Medicare Prior Authorization Model for Repetitive Scheduled Non-Emergent Ambulance Transport. The extension of this model is applicable in certain states only.
AMA’s CY 2021 CPT Codes Set Release
The code set released in the start of September 2020, modified E/M office visit codes 99201 through 99215 will enable physicians to select the code levels based on medical decision-making or total time. These new updates are proposed for adoption by the Centers for Medicare and Medicaid Services on Jan. 1, 2021.
Advance Beneficiary Notice of Non-coverage (ABN) Updates
Changes to the Advance Beneficiary Notice of Noncoverage (ABN), Form CMS-R-131, is issued by providers (including independent laboratories, home health agencies, and hospices), physicians, practitioners, and suppliers to Original Medicare (fee for service - FFS) beneficiaries in situations where Medicare payment is expected to be denied.
CARDIOLOGY BILLING SERVICES IN KENTUCKY KY
Our Billers in the state of Kentucky are specialized to service medical practices as per the regulations of the state government. Their knowledge and experience has been acquired by years of efforts in perfecting medical billing procedures which they now leverage to help your practice collect more revenue.
Evaluation and Management EM Services Guidelines
The inclusion of time in the definitions of levels of E/M services has been implicit in prior editions of the CPT codebook. The inclusion of time as an explicit factor beginning in CPT 1992 is done to assist in selecting the most appropriate level of E/M services.
Invasive Non-invasive and Interventional Cardiology
Cardiology is a section of medicine where cardiologists are involved in the study, diagnosis, and care of the cardiovascular system. The heart’s function doesn’t have many features so cardiologist has to consider some variables when identifying what goes wrong with a patients’ heart. Some variables are as follows hear, arteries, or blood vessels.
ICD-10 code for diabetes mellitus type 2
Type 2 diabetes is a chronic disease. It is characterized by high levels of sugar in the blood. Type 2 diabetes is also called type 2 diabetes mellitus and adult-onset diabetes. That's because it used to start almost always in the middle- and late adulthood.
CMS Strategy to fight the Opioid crisis
In 2018, President Trump signed the Substance Use-Disorder Prevention that Promotes Opioid Recovery and Treatment for Patients and Communities Act, or the SUPPORT for Patients and Communities Act, into law, which mobilized Federal efforts to address the nation's ongoing opioid crisis.
Percutaneous Coronary Intervention CPT® Coding
Percutaneous coronary intervention (PCI) coding brings to mind Winston Churchill’s line about “a riddle wrapped in a mystery inside an enigma.” Making assumptions about what certain descriptor terms mean and which services are bundled into PCI is sure to lead to errors.
CY 2020: Common DME Modifiers
When billing for durable medical equipment (DME), use the appropriate HCPCS code and modifier(s) to describe the items being billed. Also include an ICD-9/ICD-10 diagnosis code indicating the medical condition for which the item has been prescribed.
Outpatient Coding and Inpatient Coding
The hospital coding and billing is truly a complex system, considering the complexity of the hospital environment. Thousands of hospital employees make sure all things are well organized and systematic at the hospital, starting from the patient billing process to the reimbursement process.
Moderate Sedation Coding
Moderate sedation is a part B covered service, with administration by the physician performing the procedure. Moderate sedation is not a hospital outpatient or ASC clinical staff service, so the coding/billing is completed by doctor as a professional fee. It is the physician associated with moderate sedation. The registered nurse under supervision may push the drugs but that person's cost is an element of facility fee.
Targeted Probe and Educate (TPE)
Targeted Probe and Educate (TPE) is the process that a Medicare Administrative Contractor (MAC) can utilize when providers are selected by Medical Review. The TPE review process may include up to three rounds of a prepayment or post-payment probe review with education.
Medicare Shared Savings Program – 2020
CMS is proposing changes to the Medicare Shared Savings Program (Shared Savings Program) quality performance standard and quality reporting requirements for performance years beginning on January 1, 2021, to align with Meaningful Measures, reduce reporting burden and specialize in patient outcomes.
Streamline your DME Billing with MBC
Medical Billers and Coders (MBC) is the leading medical billing service provider that not only help with 70% operational cost reduction but also with the dedicated account manager and robust reporting in line with client protocol. Providing the very best collection rate and productivity metrics.