Medical Coding
2015 CPT coding changes that are taking effect will mostly cause issues with billings, and denials of billings that are not coded correctly according to the new Coding Rules. In the radiology practice there are not an extraordinary number of changes, but they are important to ensure proper payments. Radiology practices must train not only their billing staff in the new coding procedures, but everyone involved in reporting procedures need to know how to document what treatments were given to ensure that proper codes are used in records and for billing.
Correct documentation is crucial for physician billing to Medicare. Over the past few years, The Department of Health and Human services has been strongly focused on correcting and minimizing healthcare fraud. Currently, evaluation and management (E/M) services are under high scrutiny, especially CPT code 99233. What does this mean for your practice, and how can you protect your assets? We’ve compiled a list of three ways to prepare for random CMS audits of 99233.
Payment variances may have many causes, but they typically land in two major categories. The first category is when a payer has updated their payment system to account for issues like a new contract fee schedule. The second major category of occurrence that can cause payment variances is when a payer has made changes to their payment system, but the configuration wasn’t successfully applied. Since both of these situations tend to happen at the start of a new contract year, that’s the time to pay attention to issues that crop up by analyzing your payment variances before they get out-of-hand.
Medical coders play a vital role in the daily operations of any healthcare provider. In addition to assigning codes for patient diagnosis, office visits, and procedures, coders must submit claims to insurers. As an integral part of your company's revenue stream, it is crucial these claims are accurate and timely. While all healthcare coders receive training, only certified professional coders are recognized professionally as leaders in their field. Healthcare Information Services employs only certified professional coders, ensuring that your claims and billing are processed in an expert manner.
Healthcare coding is constantly in a state of change. Since ICD-10’s implementation, we’ve done our best to keep you informed and updated on all decisions, changes, and clarifications. Following proper coding practices increases the likelihood of prompt payment and keeps processing as efficient as possible. Below I’ve included a breakdown of changes and updates regarding […]
One of the biggest challenges any radiology practice faces is accurate coding. The right coding procedures can make the difference between a smooth revenue cycle and quick reimbursements, and a drawn-out process that costs the clinic money and leads to delays in reimbursements. The adoption of ICD-10 codes led to changes in radiology coding. At Healthcare […]
October 1st, 2015 marked the official transition of the long anticipated ICD-10 coding guidelines going into effect. While there was no “transition period”, medical practitioners were told well in advance that they would have to completely make the change to ICD-10 by the first of October 2015. Hospitals and medical practices all over the United […]
The Healthcare Information and Management Systems Society and Workgroup for Electron in Data Interchange recently released a report on ICD-10’s national pilot program. The results within this report found that only 63% of submitted ICD-10 codes were complete and precise. Although this finding occurred prior to the ICD-10 coding system being enforced on October 2015, […]
Since the conversion from ICD-9 to ICD-10 in October 2015, there have been many questions regarding the switch. At HIS, we understand the stress and confusion this change may cause for healthcare providers and their staff. ICD-10 is much more complex than previous coding systems in effect for the last 30 years. Though change can […]
In 2012, Centers for Medicare and Medicaid Services (CMS) published a rule that would require providers to report and refund any overpayments within 60 days from the date the overpayment was found. As an orthopedic provider, you have probably received some of these notices from Medicare. However, due to the amount of comments and extensive […]
The increasing competition in private practices puts a significant burden on your shoulders. You’re no longer just required to deliver excellent results but you also want to cut on costs by increasing efficiency to maximize resources.
According to a recent report, the trend for hospital physician employment may not be as beneficial to hospitals and physicians as some previously thought. Although there may be some advantages for physician groups to be owned by a hospital, by and larger there are numerous of reasons such an arrangement may not be the best one.