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.
Teaching Doctors Have a New Way to Document E/M
Rules are changed for teaching physicians documenting Evaluation and Management (E/M) codes being reported to Medicare July 29, 2019. These changes are part of the Center for Medicare & Medicaid Services’ (CMS) revamp of E/M payments. This will affect medical coders and billers, especially those working in clinical documentation improvement. Changes Part of E/M Revamp Effort The change relaxes the long-standing requirement that teaching physicians re-document information documented by residents and the medical team. This is part of CMS’ response to physicians and facilities’ request to simplify documentation and E/M decision making in general following nation-wide meetings. It also allows teaching physicians to join their non-teaching peers in …
9 Ways to Improve Health IT Interoperability and Patient Data Access
“The Healthcare Leadership Council (HLC) and the Bipartisan Policy Center recently issued a report outlining nine ways the public and private sector can work together to advance health IT interoperability and improve patient data access. Many recommendations included in the report align with newly-released proposed rules from CMS and ONC intended to crack down on information blocking. The report incorporates feedback from more than 100 clinicians and healthcare leaders from hospitals, health systems, health plans, life sciences organizations, health IT companies, and patients gathered in a year-long effort. The report aims to streamline the flow of health information across health IT systems and care settings. “Critical patient information is getting …
Return on Investment in Healthcare
Professor William A. Hyman has a good article on ROI over at Hitech Answers… “The usual meaning of Return on Investment (ROI) in purely financial transactions is how much money do you get back for the amount of money you put in. It is usually desirable for the amount returned to exceed the amount invested, thus achieving a positive ROI. In healthcare this concept requires modification because of who may receive the benefit and whether or not that benefit is monetary. Here our concern is usually investments in IT, although there are many other possibilities such as medical devices. In some hospital “investments” there can be an internal positive return …
Interoperability Questions to Consider During EHR Selection
“Improving interoperability is the central focus of several CMS federal incentive program policies, ONC initiatives, and new partnerships between EHR vendors and health data exchange services providers. Healthcare’s inability to achieve the level of seamless information exchange now common among other industries — such as banking — frustrates healthcare stakeholders across the industry. In a September 2018 survey, nearly 40 percent of physicians cited the current lack of interoperability in healthcare as a primary source of dissatisfaction. While there is no silver bullet that will solve the interoperability problem overnight, there are steps healthcare organizations can take to improve their ability to exchange patient health information with outside hospitals, health …
61% of Physicians Say EHR Systems Reduce Clinical Efficiency
“EHR systems continue to fall short of provider expectations and detract from the joys of practicing medicine, according to a recent national survey by The Doctors Company. More than 3,400 physicians from 49 states and the District of Columbia offered their perspective on EHR technology, federal regulations, value-based care, patient-centered medical homes (PCMHs), and other aspects of the healthcare system. Survey respondents included surgical specialists, primary care providers, and nonsurgical specialists. The majority of respondents were 51 and older. Overall, the majority of surveyed physicians reported that EHR systems have had a negative impact on the patient-provider relationship, clinical workflows, and clinical productivity. Fifty-four percent of surveyed physicians stated their …
Billing and coding for advanced clinical practitioners
Melissa’s Mention… “A 67-year-old patient with diabetes shows up for her appointment. Her A1C levels are high. She reveals during the visit with the advanced practice clinician that she’s not taking her medication as prescribed. The patient’s physician is doing rounds at the hospital and is, thus, unavailable to consult with the patient in person. At this point, the practice needs to answer a couple questions: Can the nurse practitioner (NP) or physician assistant (PA) bill the visit under his/her own national provider identification (NPI) number? Or, is the visit appropriate for “incident to” billing and, thus, billable under the physician who created the patient’s care plan? …
Are Health Record Guidelines the Same in Every State?
Health professionals typically know many federal guidelines instruct how to handle patient health records. However, they may not understand whether such guidelines differ from state to state. Getting clarification on that matter is essential, particularly when people move to other places after practicing in one for extended periods of time, or if they work as traveling providers on short-term assignments. Medical Retention Time Frames Vary by Location One of the specifics health providers must comply with during their patient care duties relates to the length of time they keep medical records. The details change based on the state. Furthermore, there are differences in retention time for hospitals versus physicians. Some …
RCM tip: Follow all payer billing guidelines
“In today’s healthcare environment, it is more important than ever that healthcare providers follow appropriate billing guidelines for each contract with third-party payers, according to Monte Sandler, executive vice president of revenue cycle management at DocuTAP. “With the various types of contracts urgent care providers are entering into with third- party insurers, it’s extremely important to follow the appropriate billing guidelines for each. For example, clinical guidelines are not necessarily the same as those for billing,” he told Becker’s Hospital Review. “Many contracts require all providers to be individually credentialed, and services to be billed under the rendering provider, whereas some contracts allow all providers to bill for services under …
Patients Cannot File HIPAA Lawsuits
A U.S. district court judge in Washington, D.C., on June 15 dismissed a case by a patient who alleged Laboratory Corporation of America, or LabCorp, violated HIPAA, reaffirming the precedent that individual patients cannot file lawsuits for alleged HIPAA violations, according to GovInfoSecurity. Here are five things to know about the case: 1. The district court’s ruling dismissed a lawsuit filed by a patient of Washington, D.C.-based Providence Hospital. According to the lawsuit, the patient underwent laboratory testing from LabCorp during a June 2017 hospital visit. During the visit, the former patient said she was instructed to submit medical information at a computer intake station that was allegedly within eyesight …
Five Tips for Better Meetings, Communication is Key
Nearly all practices can benefit from improved communication. In this column, I’ll be sharing some tips for making meetings productive and efficient. Reaching out to groups within your practice can improve morale, invigorate and encourage problem solving, and generally make your work life more pleasant and profitable. 1) Reinforce what is important and solidify culture. Any opportunity to communicate with a group is an opportunity to build a common understanding of the goals and challenges facing the practice. Without this holistic understanding, how can you expect staff to show any initiative beyond their narrow job description? Accordingly, be sure to point out how staff’s activities advance your strategic objectives and …
