Medical Billing Blog: Section - Medical Coding
Archive of all Articles in the Medical Coding Section
This is the archive containing links to all articles written in the Medical Coding section of our blog.
Click any of the article links below to read the entire article or browse another section to the right to read articles on another subject.
RCM tip: MACRA calls for a cross-departmental effort
Healthcare organizations should seek cross-departmental collaboration in preparing to manage and execute Medicare Access and CHIP Reauthorization Act initiatives, according to Joncé Smith, vice president of revenue cycle management at Stoltenberg Consulting. Ms. Smith shared the following tip with Becker’s Hospital Review. “Although many may see the IT department as the owner of an initiative like MACRA, true progress can only be achieved from a cross-departmental collaboration among financial, clinical and IT departments. Financial leaders serving on this committee should be responsible for managing the organization’s reporting path, including working with clinical leaders to select the appropriate program measures under either the APM or MIPS track. After all, these program …
Medicare is Still Behind on Telehealth
Medicare has long been criticized for its narrow restrictions on the coverage and reimbursement of telehealth services. A new report to Congress by the US Government Accountability Office (GAO) shows that not much has changed over the years. Mandated by the Medicare Access and CHIP Reauthorization Act, the GAO report noted that Medicare and the US Department of Defense (DoD) trailed the Veterans Affairs (VA) system in their use of telehealth and remote patient monitoring (RPM). On the other hand, the report painted an optimistic picture of Medicare demonstrations and new care delivery models that, it said, might increase the use of telehealth in Medicare. But Gary Capistrant, chief policy …
Paper-Based Billing is Ancient History in Healthcare
“Today’s realities are that managing a practice is more complicated than ever…” That’s how an assessment begins on what it takes to successfully run a medical group in 2017 by Triple Tree, a merchant bank focused on healthcare. In a recent report, the bank also looked at the forces driving mergers of specialty groups. Chief among them is the realization by administrators and their physicians that the healthcare business isn’t what they hoped it would be. The mounting pressures are affecting medical groups’ top and bottom lines. The bank’s report suggests that while opting to be part of a larger group might sound attractive to an independent practice, the non-clinical …
14 things to know about medical coding
Medical coders play a crucial role in the revenue cycle process, as they help ensure health systems, hospitals and physicians are properly reimbursed for the services they provide. Here are 14 things to know about medical coding. 1. AAPC describes medical coding as “the transformation of healthcare diagnosis, procedures, medical services and equipment into universal medical alphanumeric codes.” 2. Once medical coding professionals assign a code to a specific healthcare service or procedure, the code is included on an insurance claim, according to AAPC. This code tells the insurer how much it owes for the care and helps determine how much the patient will be billed. 3. Coders use a …
ICD-11 Beta is available in the trials at WHO
If you are tired of ICD-10, you can go checkout ICD-11 at WHO’s website. ICD-11 Beta is available in the trial stages. Visit the current version of ICD-11 on the World Health Organization website
5 biggest concerns for health execs in 2017
A new set of concerns has emerged among hospital and health system executives, according to The Advisory Board Company’s latest Annual Health Care CEO Survey. The survey, which was completed by 183 C-suite executives between December and January, found the No. 1 concern among health system leaders in 2017 is improving patients’ access to care in ambulatory or outpatient settings. Last year, this concern was ranked No. 6. An entirely new concern — finding innovative ways to lower expenses — came in at second place. The No. 3 concern was boosting market share for outpatient surgical procedures, up from No. 10 in 2016. “This shift in topic rankings reflects a …
Self-service data preparation and analytics
Improving claim collection rates is one way to boost revenue cycle performance, and hospitals can achieve this through various means. Frank Moreno, vice president of product marketing at Datawatch, shared the following tip with Becker’s Hospital Review:”Effective revenue cycle management is only attainable when healthcare organizations have a full view of their patient and operational data. Finance departments cannot wait for IT to provide detailed reports, or spend countless hours manually pulling data from EMRs, 835 and 837 remittance and other files.Yet that’s what is happening at organizations across the country every day. Instead, by using self-service data preparation and analytics solutions, finance teams can easily unlock hidden data to …
Seven Steps to Correctly Code Surgeries
It’s all in how you dissect the operative report. Many coders struggle with coding operative reports because there are so many guidelines and policies that affect code selection. The process is easier when you break it into seven steps: Review the header of the report. Review the CPT® codebook (start in the Index). Review the report/documentation. Make a preliminary code selection. Review the guidelines (for the preliminary codes). Review policies and eliminate the extras. Add any needed modifiers. These seven steps will ensure all the factors that may affect code selection are accounted. Let’s look at an example, and walk through the steps together. Step 1 Review the Header of the …
7 things to know about medical coding and billing specialists
Medical coding and billing specialists are an integral part of hospitals’ and health systems’ efforts to optimize revenue cycle management processes. Here are seven things to know about medical coding and billing specialists. 1. Medical coders are tasked with reviewing clinical documentation and designating standard codes using ICD-10 classifications. Medical billers primarily process and make sure claims are sent to payers for reimbursement of services administered by a provider, the American Academy of Professional Coders states. 2. A hospital or a health system may combine the responsibilities of coding and billing into a single department, or may divide coding and billing operations into two separate branches. AAPC states if the …
