Picking the right coding vendor can be challenging. There so many options and they all tell you they offer accurate coding to ensure revenue optimization and compliance risk minimization. To help you select the right coding vendor, we have compiled some considerations to help narrow down your decision. Always ask if the codes that they [...]
There is no such thing as a coder who knows it all. If your coder claims to be able to code every specialty, and you let them, you might want to get your checkbook ready to pay back some recoupments. There are over 70,000 ICD-10 codes and 10,000 CPT codes. The wealth of knowledge is [...]
A troubling trend in the medical coding industry is a misleading split model where companies will have resources both onshore and abroad but not disclose which personnel are performing the services. Some use their domestic resources almost exclusively for client facing interactions, such as sales and operations, but send all of the coding work to [...]
Cross training sounds like it should work. A coder is a coder. Why pay a new coder to work on Orthopedics when you have two OB/GYN coders with extra capacity? The job title is the same, the job itself is the same, the software/system access/workflow are the same. Yet this thinking can get a practice [...]
After Oct. 1st, your currently paid claims can suddenly turn into denials After the ICD-10-CM transitional grace period, Medicare will no longer pay claims with diagnosis codes that are CLOSE to accurate. And to make it worse, payers haven't been telling you what's wrong with the claims you've submitted incorrectly, so fixing the problem can [...]
John F. Lehrian, who is retired, and David E. Palo, of what was known as Lehrian & Palo Oral Surgery, 100 State St., pleaded not guilty to federal charges that they the defrauded insurance companies of more than $323,000. They were indicted July 12 on charges of health care fraud. The government is alleging Lehrian [...]
The extreme predictions about the negative effects of moving to ICD-10 just didn’t happen. Now, over eight months later, one of the country's leading organizations which has been tracking the ICD-10 transition says that there have been minimal effects at best. Read the full story here: https://www.healthdatamanagement.com/news/the-transition-to-icd-10-was-easier-than-expected
Now that ICD-10 has been rolled out, medical coding companies are feeling its effects. The Medical Group Management Association (MGMA) and its affiliates are having to recreate their processes in order to account for the vast increase in the number and variety of codes. What was once a simple system with a mere 13,000 codes is [...]
The much delayed launch of ICD-10 code implementation finally occurred on Oct 1st, 2015. The new International Classification of Diseases, Revision 10 inflates coding options by the thousands and requires more specificity than ever before. Among the standards, the new injury codes expanded to include some pretty crazy ways people have been [...]
The MGMA reports that the final 2016 Medicare physician fee schedule has been released. The Centers for Medicare & Medicaid Services (CMS) finalized the Medicare physician fee schedule (PFS) for 2016. Key policies finalized in the 2016 payment rules include: Finalizing the Home Health Value-Based Purchasing model. Finalizing updates to the “Two-Midnight” rule. Finalizing the [...]
