Coding & Documentation

There’s no doubt prior authorizations are a major time suck. Here are five ways to make them a little less onerous.

If providers fail to follow these new rules, claims will be denied, and eventually, those who are outliers on adherence to appropriate use criteria will be subject to prior authorization.

Though similar to other specialties, some billing codes are unique for behavioral therapy.

A transparent, data-driven approach can ease the transition from traditional fee-for-service to value-based contracts.

Don’t let your Medicare Part B reimbursement for advanced imaging be impacted by the CMS Mandate taking effect on January 1, 2022!

Miscoding and fraudulent billing can destroy a medical practice. Use these tips to get robust oversight of your medical billing and coding in place.

There are two principal criteria that need to direct physicians’ code assignment once they have decided to use a TCM code.

How do we guide the next generation of clinicians to prioritize value over volume?

2021 has brought about the most extensive changes to CMS’s Evaluation and Management (E&M) guidelines since 1997.

Covered entities should be balancing a patient’s right to request his/her medical records or designated record set in a particular electronic format with an unacceptable level of security risk to the covered entity’s systems.

Our experience shows how key features of value-based care can position practices to be more resilient, adaptable, and future-oriented.

How reinforcing care coordination can create value and improve patient outcomes.

Tips physicians should be using to ensure accurate documentation while protecting their professional integrity.

Are they really gone?

Eight areas that require your thought and attention at the beginning of the year.

Providers will benefit most from well-tailored RPM programs designed within the current requirements that also have the means to be flexible as requirements inevitably shift.

Computational resources are catching up with all of the healthcare data that’s been accumulating.

Waiting to change could negatively affect business

Scott LaRoque, CEO of MPOWER Health, discusses why some physician practices are hesitant to adopt value-based care models and how practices can get started with them.

2021 EM guidelines turn some traditional 99213s into 99214s.

This month’s Coding Q&A features questions from a physician coding for time spent with hospital patients, and another wondering if there is another way to code for medical reconciliation outside of Transitional Care management codes.

The time for PCPs to focus on improving documentation, coding, and value-based care initiatives is now.

CDI can be a critical initiative that not only increases reimbursement revenue but also enhances the patient experience.

Answers to your latest coding questions

HIPAA settlement and new guidelines shed light on government enforcement policies.

Why practices should not fear new coding requirements

Should providers should include notes in an EMR so insurance companies see CC statement? CMS vs CPT Code Book hospital admission coding. Plus, a clarification on guidelines when coding for telehealth visits.

A generalized checklist for your planning. 

How his experience contracting and recovering from the disease has shaped his perspective.

Remote visits and online E&M services.