Identifying the Components of a High-Risk Evaluation and Management Service
Since 2021, when the Office and Other Outpatient Evaluation and Management (E/M) services coding guidelines changed to require only scoring by time or medical decision making (MDM), coders, providers, and facilities have worked hard to implement chan...
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Defining Modifier 25
Yes! Considering the recent uproar caused by one payer's plan to implement a policy requiring prepayment review of documentation for all visits billed with 99212-99215, modifier 25, and a minor procedure, it is clear there is still a need to discuss ...
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Are You Properly Reporting Radiology Services?
It's probably not surprising that the most commonly billed imaging services are radiologic examinations of the humerus, spine, fingers, and abdomen (codes 72070, 73060, 73140, and 74019).
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If a Procedure Was Not Documented, Was It Performed?
Most of us, if not all of us, have heard the statement, "If it isn't documented, then it wasn't performed." While I know this is often the perspective of payers, I cringe when I hear this, thinking about all the providers that I work with and the fac...
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Freestanding Emergency Center (FEC) Industry Lobbying Goes to Washington
In early February, members of the National Association of Freestanding Emergency Centers (NAFEC) went to Washington D.C. to meet with various members of Congress to gain support for two items: the continued recognition of Freestanding Emergency Cente...
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2023 Navigator® Radiation Oncology
This industry-leading reference manual is one of Revenue Cycle Coding Strategies® most popular products, year after year.
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2023 Navigator® Diagnostic Radiology Billing Compliance
This comprehensive and easy-to-use medical coding book is indispensable for compliance officers, administrators, billing managers, and anyone else involved in billing compliance for radiology services. ...
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Let's Talk Prolonged Services! Did you report all of your time?
Prolonged preventive services are provided in outpatient settings and can be provided via telehealth. Annual wellness visits and the Welcome to Medicare visit include a thorough review of the patient's health and medical history. The physician perfor...
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PSQIA, PSWP, and HIPAA Compliance
This article addresses patient confidentiality and security related to patient safety evaluation systems, investigations, root cause analyses, and compliance to rules and regulations. It is a basic introduction to help understand the importance...
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Keys to Correct Embolization Coding: CPT® Codes 37241-37244
It is no secret that interventional radiology is one of the most difficult specialties for coders and auditors to master. In particular, coding correctly for embolization procedures can be tricky due to the multiple coding considerations involv...
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What's Going on With the COVID Vaccines Now?
Keeping up with the changes to the COVID vaccines has certainly been a rollercoaster ride, and we now have two new twists to this exciting ride. Twist one comes from the FDA who recently pulled the emergency use authorization (EUA) for the monovalent...
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Overcoming Self-Pay Challenges in Revenue Cycle Management
Amid the headlines of labor shortages and hospital closures, many Americans may have missed some positive recent healthcare-industry news: The U.S. reached a new, all-time low in the rate of Americans without health insurance. ...
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