Tracking Key Metrics for Laboratories and Diagnostic Providers

Tracking key metrics like clean claim and write-off rates is key to laboratories and diagnostic providers maximizing revenue. Submitting clean claims is one of the most important ways that a diagnostic organization can ensure payment in a timely manner from both private and government insurance payers. Receiving the maximum reimbursement the first time a claim […]

Newly Added CPT Codes for COVID-19 Antibody Tests

The American Medical Association (AMA) on April 10, 2020, announced updates to Current Procedural Terminology (CPT®) that include two CPT Codes for COVID-19 Antibody Tests, intended to report when patients receive blood tests that detect COVID-19 antibodies. The updates were approved during a special meeting of the CPT Editorial Panel, the independent body convened by […]

How to increase patient collection in 2020?

As more healthcare bills go to patients themselves, many hospitals and health systems find their existing collections strategies fall short. Traditional solutions are built to collect from insurance companies, not directly from patients. This practice leaves providers exposed to an unpredictable financial landscape where the health of their revenue cycle rests on their patients’ ability […]

Telehealth Coverage Policies during COVID-19 Pandemic

Updated on April 6, 2020, as things rapidly develop regarding what we know about COVID-19, telehealth coverage policies have also been developing alongside it. Below is a summary of what is covered by various public and private payers with the information that has been released. Medicare Fee for Service Telehealth Coverage SUBJECT AREA CURRENT POLICY […]

Telehealth Coverage Expanded for Medicare Beneficiaries

A sweeping expansion of telehealth coverage for Medicare beneficiaries is being implemented to aid in the healthcare needs of those with the coronavirus, or COVID-19. The Centers for Medicare & Medicaid Services (CMS) announced in a March 17, 2020, press release that it will make a temporary change in its reimbursement policy for telehealth services. […]

Medicare Advantage Plan Coverage and Payment Related to COVID-19

Medicare Advantage plan (also known as “Part C”) is an “all in one” alternative to Original Medicare. Medicare Advantage plans cover Medicare Part A and Part B services, and usually prescription drugs covered under Medicare Part D. These plans also may offer extra benefits Original Medicare doesn’t cover. Medicare Part D also called the Medicare […]

Are you correctly Using 99291 and 99292 codes?

Critical care is the direct delivery by a physician(s) of medical care for a critically ill or injured patient. The care of such patients involves decision making of high complexity to assess, manipulate, and support central nervous system failure, circulatory failure, shock-like conditions, renal, hepatic, metabolic, or respiratory failure, postoperative complications, overwhelming infection, or other […]

Coding for Opioid Use and Counseling

For any case of pregnancy in which a woman uses opioids during the pregnancy or postpartum period, codes from subcategory O99.32, Drug use complicating pregnancy, childbirth, and the puerperium, should be assigned. A secondary code from category F11, Opioid-related disorders, should also be assigned to identify the manifestation of Opioid Use and Counseling. Opioid Use […]

Controlling Gestational Diabetes

Gestational diabetes is diabetes that a woman can develop during pregnancy. When you have diabetes, your body cannot use the sugars and starches (carbohydrates) it takes in as food to make energy. As a result, your body collects extra sugar in your blood. We don’t know all the causes of gestational diabetes. Some—but not all—women […]

ICD-10 Codes – Type 1 Diabetes Mellitus

Diabetes means your blood glucose or blood sugar is too high. With type 1 diabetes, your pancreas does not make insulin. Insulin is a hormone that helps glucose get into your cells to give them energy. Without insulin, too much glucose stays in your blood. Over time, high blood glucose can lead to serious problems […]

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