Specifying anatomical location and laterality required by ICD-10 is easier than you think. This detail reflects how physicians and clinicians communicate and to what they pay attention to – it is a matter of ensuring the information is captured in your documentation. In ICD-10-CM, there are three main categories of changes Definition Change; Terminology Differences; […]
Ambulatory Surgical Center Terminated Procedures The following guidance determines the appropriate ambulatory surgical center (ASC) facility payment for a scheduled surgical procedure that is terminated due to medical complications, which increase the surgical risk to the patient. Payment is denied when an ASC submits a claim for a procedure that is terminated before the patient […]
Cardiology billing services are designed to help you maximize collections by meeting government regulations and private payer requirements. Since 2016 when ICD-10 became the official code set for the United States we saw several changes to cardiovascular diagnosis codes. No more hypertension table, we now have a new way to code hypertension (I10 – I15). […]
With the new 2020 ICD-10-CM code set now available, we know that there have been more than 740 different changes. More than 30 of the changes for 2020 actually apply to Obstetrics and Gynecology (OB-Gyn) correction, from changes and updates to coding multiple gestation pregnancies to coding for obstetric surgical wound infections. Here’s a closer […]
Consolidated Billing Background Prior to the Balanced Budget Act of 1997 (BBA), an SNF could elect to furnish services to a resident in a covered Part A stay, either: directly, using its own resources; through the SNF’s transfer agreement hospital; or under arrangements with an independent therapist. The consolidated billing requirement confers on the SNF […]
Claims Denials for OB/GYN are a thorn in the flesh for most medical practices. However, some specialties have an exceptionally high denial rate. Unfortunately, OB/GYN is one of them. Denial rates in this specialty are the highest, at 22.42%. Denials are an everyday occurrence for most OB/GYN centers. OB/GYN billing and coding present unique challenges […]
Healthcare Revenue Cycle Management Healthcare Revenue Cycle Management professionals use information technology to track claims throughout their lifecycle. This is necessary to ensure payments are collected and denied claims are addressed. However, some hospitals struggle to implement information technology and billing infrastructure that successfully manages claims and large outpatient networks. Effective health information technology is […]
By law, Medicare payment for outpatient mental health services is limited to 62.5 percent of covered expenses incurred in any calendar year in connection with the treatment of a mental, psychoneurotic, or personality disorder for an individual who is not an inpatient of a hospital at the time the expenses are incurred. Unfortunately, when you […]
The SNFABN provides information to the beneficiary so that he can decide whether or not to get the care that may not be paid for by Medicare and assume financial responsibility. SNFs must use the SNFABN when applicable for SNF Prospective Payment System services (Medicare Part A). SNFs will continue to use the ABN Form […]
For the 2018 reporting period, insufficient documentation accounted for 81.6 percent of improper payments for ostomy supplies. Additional types of errors for ostomy supply claims in the 2018 reporting period were no documentation (2.3 percent) and medical necessity (1.9 percent). Medical records must contain adequate, clear documentation that supports the medical necessity of the amount […]
Connect with us by filling out this form. Let’s tailor a
solution that fits your needs perfectly.
Specialities
Services
Resource Center
Pricing
About
Contact
