E/M office and other and other outpatient visit guidelines will be changing as of January 1, 2021. Below are further details regarding these changes: Read Part I and Part II of this blog for more information. Major E/M revisions for 2021 regarding time of patient encounters include Extensive E/M guidelines additions, revisions, and restructuring Deletion of code 99201...

Conducting regular audits of your coding and billing procedures is a great way to identify and eliminate upcoding and incorrect coding incidences within your practice. In a recent article from Becker’s , it is estimated that hospitals overbilled Medicare by $1 billion from inaccurate coding. The office of Health and Human Services (HHS) Office of Inspector General cited...

When you are considering the pros and cons of a variable vs fixed cost structure, don’t overlook certain specialty areas such as registries. For example, On April 2, 2020, the American College of Surgeons (ACoS) sent out a newsletter stating that ACS Accreditation and Verification Programs have been granted an extension of one year for hospitals currently accredited and...

With our E/M office or other outpatient visits guidelines changing on January 1, 2021, below are the details explaining the changes. Read part 1 of this article HERE.   Choosing the correct E/M level beginning January 1, 2021 is based on:  The level of medical decision making (MDM) as defined for each service; or  The total time for E/M services performed on the date of...

It has been almost 30 years since evaluation and management (E/M) office visit documentation and coding has been changed.  These changes take place beginning January 1st, 2021.  The revised guidelines will improve documentation redundancy and support medical necessity.  In the past, the code selection was based on 3 key elements (history, examination, and medical...

As we continue to feel the impact of COVID-19 in the United States and continue canceling meetings to avoid travel and risks of exposure, many families are also concerned about their loved ones currently going through cancer treatment.  And many others are currently being diagnosed with cancer during this worldwide pandemic.  The big question is how does this impact...

The current pandemic has prompted the World Health Organization (WHO) to take the unusual step of establishing a unique ICD-10 code for COVID-19 cases, U07.1 five months prior to the traditional U.S. implementation date for new codes. The use of the code became effective with April 1, 2020 discharges and was accompanied by updated coding guidance to the ICD-10-CM Official...

What Does CMS Say?  Congress passed wavier 1135 that states Medicare and other commercial carriers have temporarily expanded services for reimbursement on several telehealth services.  Click here for list of covered services during this Public Health Emergency (PHE) due to COVID-19.  For additional information on COVID-19, click here.  CMS is now releasing News Alerts...

Making changes on the fly is never easy in any industry, especially healthcare - figuring out what platform to use, training staff and patients on how to operate video conferences, but more importantly, will you get paid? With the Corona Pandemic turning our revenue cycle upside-down due to the cancelling of most elective procedures, it’s more important than ever that we...

In this environment it’s hard to know what tomorrow will bring. If you watch the news, all you’ll see is a lack of hospital beds and overwhelming patient volumes. Meanwhile, hospitals and clinics around the country are laying off staff because elective and non-emergent procedures have been cancelled to clear the decks for COVID patients. To add to the complexity, many...