Revenue Cycle Insider
Procedure Focus:
Get the Answers to Your Frequently Asked Anesthesia for GI Endoscopy Questions
Remember: the dx you report may not be related to the GI condition. While some physicians... Read more
Get the Answers to Your Frequently Asked Anesthesia for GI Endoscopy Questions
Remember: the dx you report may not be related to the GI condition. While some physicians... Read more
Documentation:
Address These Key Fields, Complete ABNs With Ease
Don’t forget that every ABN form must be one single page. As every anesthesiology pract... Read more
Address These Key Fields, Complete ABNs With Ease
Don’t forget that every ABN form must be one single page. As every anesthesiology pract... Read more
Practice Management:
Try These Tips for Boosting Financial Literacy
Hint: Make sure you involve providers, so they understand the ripples of their work. Maki... Read more
Try These Tips for Boosting Financial Literacy
Hint: Make sure you involve providers, so they understand the ripples of their work. Maki... Read more
CPT® 2025:
Adopt These E/M Changes Before January 1 Hits
Say goodbye to 99441 through 99443 next year. When CPT® 2025 becomes effective on Jan. 1... Read more
Adopt These E/M Changes Before January 1 Hits
Say goodbye to 99441 through 99443 next year. When CPT® 2025 becomes effective on Jan. 1... Read more
2025 Updates:
Get Ready For New 2025 Category III Codes
Remember: Category III codes have an expiration date. Although you won’t gain any new c... Read more
Get Ready For New 2025 Category III Codes
Remember: Category III codes have an expiration date. Although you won’t gain any new c... Read more
Education:
Conquer Coding Education Challenges With Expert Advice
Consider starting with E/M concepts first. In their 2024 HEALTHCON session titled “Tag... Read more
Conquer Coding Education Challenges With Expert Advice
Consider starting with E/M concepts first. In their 2024 HEALTHCON session titled “Tag... Read more
Reimbursement:
Join WCA In Their Fight Against Optum Per Diem Payment
Wisconsin OCI to scrutinize whether Optum limits access to quality chiropractic care. ... Read more
Join WCA In Their Fight Against Optum Per Diem Payment
Wisconsin OCI to scrutinize whether Optum limits access to quality chiropractic care. ... Read more
Coding:
Wield Your Imaging Edge With the New X-ray CPT® Codes for 2016
Enjoy wider range of Code choices for spinal X-rays. There’s a lot to learn from... Read more
Wield Your Imaging Edge With the New X-ray CPT® Codes for 2016
Enjoy wider range of Code choices for spinal X-rays. There’s a lot to learn from... Read more
Reimbursement:
Make the Most of 0.5 Percent Increase in Medicare Physician Fee Schedule
Noncompliance with EHR and PQRS to affect the non participating providers. Get ready f... Read more
Make the Most of 0.5 Percent Increase in Medicare Physician Fee Schedule
Noncompliance with EHR and PQRS to affect the non participating providers. Get ready f... Read more
Procedure Coding:
Answer These Questions to Code Lesion Removals Correctly
Always wait on pathology report before deciding on malignancy. Dermatology coders look... Read more
Answer These Questions to Code Lesion Removals Correctly
Always wait on pathology report before deciding on malignancy. Dermatology coders look... Read more
Case Study Corner:
Improve Lesion Removal Smarts with These Scenarios
You might be able to report a separate E/M in some instances. Check out these case stu... Read more
Improve Lesion Removal Smarts with These Scenarios
You might be able to report a separate E/M in some instances. Check out these case stu... Read more
Compliance:
Make Medicare Status Change Before 2017
Remember: Participating providers receive five percent higher fees for services. As th... Read more
Make Medicare Status Change Before 2017
Remember: Participating providers receive five percent higher fees for services. As th... Read more
Coding:
Let These 3 Tips Lead You to New vs. Established Patient Clarity
You can collect more for new patients — but check these guidelines first. What’s the... Read more
Let These 3 Tips Lead You to New vs. Established Patient Clarity
You can collect more for new patients — but check these guidelines first. What’s the... Read more
Continuing Education:
Use This Guidance to Improve Your Coding Education Process
Check out these tips for more effective clinician communication. Coding education is an... Read more
Use This Guidance to Improve Your Coding Education Process
Check out these tips for more effective clinician communication. Coding education is an... Read more
Compliance:
Review This False Claims Act Case, Learn How to Avoid Big Fines
Strengthen your understanding of MDM guidelines. As you may know, the Department of Just... Read more
Review This False Claims Act Case, Learn How to Avoid Big Fines
Strengthen your understanding of MDM guidelines. As you may know, the Department of Just... Read more
Inpatient Facility:
3 Ways to Make More Strategic Decisions For Your Rehab Facility
Making time for training pays off in unexpected ways. Growing up in Kentucky, Renee Ki... Read more
3 Ways to Make More Strategic Decisions For Your Rehab Facility
Making time for training pays off in unexpected ways. Growing up in Kentucky, Renee Ki... Read more
ABNs:
Prevent Lost Revenue for Uncovered Procedures
Meet with your patients to improve ABN success. Good news, rehab providers: A signed a... Read more
Prevent Lost Revenue for Uncovered Procedures
Meet with your patients to improve ABN success. Good news, rehab providers: A signed a... Read more
Regulations:
Final Rule Roundup
Get a breakdown of the key provisions in the final rules that will impact your practice ... Read more
Final Rule Roundup
Get a breakdown of the key provisions in the final rules that will impact your practice ... Read more
Procedure or ED E/M?:
Use This Guidance for Treating Lacerations With Surgicel
Report with wound repair codes, include in E/M code … or something else? Laceration re... Read more
Use This Guidance for Treating Lacerations With Surgicel
Report with wound repair codes, include in E/M code … or something else? Laceration re... Read more
CPT® Basics:
Decipher the Symbols in Your CPT® Code Book for Easier Code Selection
These notations can help coders better master each code’s guidelines and descriptors. ... Read more
Decipher the Symbols in Your CPT® Code Book for Easier Code Selection
These notations can help coders better master each code’s guidelines and descriptors. ... Read more
ICD-10 Coding:
Update Your Understanding of Asthma Coding
And don’t forget cause/effect sequencing. Earlier this year, the Centers for Disease C... Read more
Update Your Understanding of Asthma Coding
And don’t forget cause/effect sequencing. Earlier this year, the Centers for Disease C... Read more
FAQ:
Check Out the Answers to These Tummy Trouble Coding FAQs
See whether pediatric stomach pain is coded differently. When it comes to stomach issues... Read more
Check Out the Answers to These Tummy Trouble Coding FAQs
See whether pediatric stomach pain is coded differently. When it comes to stomach issues... Read more
Practice Management:
Understand the 5 Challenges Remote Workers Face
Craft effective policies to maintain compliance. Remote workers face several challenges... Read more
Understand the 5 Challenges Remote Workers Face
Craft effective policies to maintain compliance. Remote workers face several challenges... Read more
CPT®:
Decipher the Symbols in Your CPT® Code Book for Easier Code Selection
These notations can help coders better master each code’s guidelines and descriptors. ... Read more
Decipher the Symbols in Your CPT® Code Book for Easier Code Selection
These notations can help coders better master each code’s guidelines and descriptors. ... Read more
Procedure Coding:
Take These 5 Tips, Accurately Code Upper GI Scope Exams
Hint: Determine how far the scope went. According to one study, the average general surge... Read more
Take These 5 Tips, Accurately Code Upper GI Scope Exams
Hint: Determine how far the scope went. According to one study, the average general surge... Read more
Coding Deep Dive:
Answer the How, What, When, and Why for Preoperative Evaluations
Don’t forget to check for comorbid conditions. Knowing how to navigate and select all ... Read more
Answer the How, What, When, and Why for Preoperative Evaluations
Don’t forget to check for comorbid conditions. Knowing how to navigate and select all ... Read more
Practice Management:
Improve Provider, Coder, Biller Relations, Improve Outcomes and Revenue
Three different roles, the same shared goals. In her presentation “Documenting and Codi... Read more
Improve Provider, Coder, Biller Relations, Improve Outcomes and Revenue
Three different roles, the same shared goals. In her presentation “Documenting and Codi... Read more
HIPAA:
Measure Your Disaster Smarts With 10 Tough Privacy Questions
Remember, HIPAA applies to volunteers, too. When a natural disaster strikes, the last thi... Read more
Measure Your Disaster Smarts With 10 Tough Privacy Questions
Remember, HIPAA applies to volunteers, too. When a natural disaster strikes, the last thi... Read more
Artificial Intelligence:
Get Ready for These AI Updates in CPT® 2023
Hint: Analyzing data is just one piece of the AI puzzle. There’s no denying that artifi... Read more
Get Ready for These AI Updates in CPT® 2023
Hint: Analyzing data is just one piece of the AI puzzle. There’s no denying that artifi... Read more
Revenue Booster:
Bolster Your Email Security with 10 Top Tips
Hint: Quiz staff on phishing ploys. Even the most tech-savvy folks get duped by email phi... Read more
Bolster Your Email Security with 10 Top Tips
Hint: Quiz staff on phishing ploys. Even the most tech-savvy folks get duped by email phi... Read more
Diagnosis Coding:
Master 7th Character Selection Injuries and Complications
Don’t look to aftercare Z codes when caring for an injury. Knowing which seventh... Read more
Master 7th Character Selection Injuries and Complications
Don’t look to aftercare Z codes when caring for an injury. Knowing which seventh... Read more
Expect More 7th Character Options for Fractures
When it comes to fractures, your Chapter 19 seventh character options expand to allow yo... Read more
When it comes to fractures, your Chapter 19 seventh character options expand to allow yo... Read more
Coding Quiz:
Can You Assign the Correct 7th Character in These Scenarios?
Take note of expanded options for fractures. While “D” for subsequent enco... Read more
Can You Assign the Correct 7th Character in These Scenarios?
Take note of expanded options for fractures. While “D” for subsequent enco... Read more
Patient-Driven Groupings Model:
Proposed 4% Budget Neutrality Adjustment Continues HHAs’ Death By A Thousand Cuts
CMS calls for an overall 1.7 percent payment reduction in 2025 proposed rule released June... Read more
Proposed 4% Budget Neutrality Adjustment Continues HHAs’ Death By A Thousand Cuts
CMS calls for an overall 1.7 percent payment reduction in 2025 proposed rule released June... Read more
Reimbursement:
Take A Closer Look At Your Proposed Rate Change
Don’t stop at base rate when gauging proposed cut’s effect on your pay. The base pa... Read more
Take A Closer Look At Your Proposed Rate Change
Don’t stop at base rate when gauging proposed cut’s effect on your pay. The base pa... Read more
Compliance:
Medicare Wants To Inspect Your Patient Acceptance Policies
New CoP would cost HHAs nearly $3.2 million in first year. Don’t be surprised if a newl... Read more
Medicare Wants To Inspect Your Patient Acceptance Policies
New CoP would cost HHAs nearly $3.2 million in first year. Don’t be surprised if a newl... Read more
ICD-10:
Final Word on ICD-10 Yet to Come
Start learning your way around the ICD-10 manual. What’s next? Ever since the su... Read more
Final Word on ICD-10 Yet to Come
Start learning your way around the ICD-10 manual. What’s next? Ever since the su... Read more
Hospice Coding:
Don't Delay: Prepare Hospice Coding Staff for Increased Focus on Diagnosis Coding
CMS asks for your input about terminal illness, related conditions definitions. Your h... Read more
Don't Delay: Prepare Hospice Coding Staff for Increased Focus on Diagnosis Coding
CMS asks for your input about terminal illness, related conditions definitions. Your h... Read more
Managed Care:
Counties Covered By MA Hospice Plans Will Nearly Double In 2022
Don’t make the mistake of thinking you won’t be affected if you don’t operate in one... Read more
Counties Covered By MA Hospice Plans Will Nearly Double In 2022
Don’t make the mistake of thinking you won’t be affected if you don’t operate in one... Read more
VBID:
5 Medicare Advantage Plans To Offer Hospice Benefit
Tip: Remember you have to bill both the managed care plan and Medicare for VBID carve-in ... Read more
5 Medicare Advantage Plans To Offer Hospice Benefit
Tip: Remember you have to bill both the managed care plan and Medicare for VBID carve-in ... Read more
Regulations:
HOPE Tool Continues Path To Implementation
November Care Compare refresh, new HQRP resources also discussed in forum. Just because... Read more
HOPE Tool Continues Path To Implementation
November Care Compare refresh, new HQRP resources also discussed in forum. Just because... Read more
Code Updates:
Prepare for Radiology Coding Changes With the 2025 ICD-10-CM Release
Specify unspecified tenosynovitis diagnoses. On Oct. 1, 2024, the Centers for Medicare &a... Read more
Prepare for Radiology Coding Changes With the 2025 ICD-10-CM Release
Specify unspecified tenosynovitis diagnoses. On Oct. 1, 2024, the Centers for Medicare &a... Read more
Code Updates:
ICD-10-CM Makes Eating Disorder Documentation More Specific
Also, synovitis/tenosynovitis combo code expands. ICD-10-CM has released its list of ne... Read more
ICD-10-CM Makes Eating Disorder Documentation More Specific
Also, synovitis/tenosynovitis combo code expands. ICD-10-CM has released its list of ne... Read more
Documentation:
Dive into Malnutrition Diagnosis Documentation
Use the GLIM criteria to help you recognize requirements. An unsupported malnutrition dia... Read more
Dive into Malnutrition Diagnosis Documentation
Use the GLIM criteria to help you recognize requirements. An unsupported malnutrition dia... Read more
Policy/Reimbursement:
Is the Current Pause of QIO Reviews a Lull Before the Storm?
Check with the QIOs for your denied claims status before you take to appeals. In a yet... Read more
Is the Current Pause of QIO Reviews a Lull Before the Storm?
Check with the QIOs for your denied claims status before you take to appeals. In a yet... Read more
Policy/ reimbursement:
Are You Ready for the MACRA Overhaul of the Existing Payment Systems?
AMA wants the implementation to be postponed to July 2017. Get ready for transition to... Read more
Are You Ready for the MACRA Overhaul of the Existing Payment Systems?
AMA wants the implementation to be postponed to July 2017. Get ready for transition to... Read more
Procedure Coding:
Make These Codes Count for School, Sports, Work Physicals
Maintain your coding fitness with preventive E/M codes. If your practice is like most int... Read more
Make These Codes Count for School, Sports, Work Physicals
Maintain your coding fitness with preventive E/M codes. If your practice is like most int... Read more
Billing:
Use These Reciprocity Rules When Your Physician Is Away
Know the dos and don'ts of reciprocal billing. Every practice has its procedures for prov... Read more
Use These Reciprocity Rules When Your Physician Is Away
Know the dos and don'ts of reciprocal billing. Every practice has its procedures for prov... Read more
ICD-10 Coding:
Take These Steps, Get Relief from Pressure Ulcer Coding
Sequencing, site, laterality, severity key to L89 specificity. As a coder, you've probabl... Read more
Take These Steps, Get Relief from Pressure Ulcer Coding
Sequencing, site, laterality, severity key to L89 specificity. As a coder, you've probabl... Read more
Quality:
Brace Yourself for Focused Surveys And Compliance Probes
Scrutiny of quality of care likely to reach new highs in 2016. The Centers for Medicar... Read more
Brace Yourself for Focused Surveys And Compliance Probes
Scrutiny of quality of care likely to reach new highs in 2016. The Centers for Medicar... Read more
MDS 3.0:
Heed These Changes to CAT Specs
Revisions are effective Oct. 1, 2016. Delirium and cognition loss are among the Care A... Read more
Heed These Changes to CAT Specs
Revisions are effective Oct. 1, 2016. Delirium and cognition loss are among the Care A... Read more
ICD-10:
Nail Down Your Understanding of ‘With’ to Boost Coding Success
Hint: Don’t depend on the alphabetic index when searching for ‘with.’ The ICD-10-C... Read more
Nail Down Your Understanding of ‘With’ to Boost Coding Success
Hint: Don’t depend on the alphabetic index when searching for ‘with.’ The ICD-10-C... Read more
News You Can Use:
Should Your Facility Invest in Gaming?
Get a glimpse of a near future where resident activities turn virtual. People of all ages... Read more
Should Your Facility Invest in Gaming?
Get a glimpse of a near future where resident activities turn virtual. People of all ages... Read more
Industry Updates:
CMS Announces Changes to SFF Program
Beware of more, expanded enforcement actions. The Centers for Medicare & Medicaid Ser... Read more
CMS Announces Changes to SFF Program
Beware of more, expanded enforcement actions. The Centers for Medicare & Medicaid Ser... Read more
ICD-10-CM:
Identify Location, Site, Complications to Choose Correct Atherosclerosis Dx
Hint: You must know if the patient also has angina pectoris or not. Coding for atheroscl... Read more
Identify Location, Site, Complications to Choose Correct Atherosclerosis Dx
Hint: You must know if the patient also has angina pectoris or not. Coding for atheroscl... Read more
Medicare Tips:
Sharpen Your Medicare Signature Knowledge
Resolving your questionable signatures prior to claim submission is key. In your medica... Read more
Sharpen Your Medicare Signature Knowledge
Resolving your questionable signatures prior to claim submission is key. In your medica... Read more
Surgery Spotlight:
Help the Slipper Fit by Coding Cinderella Surgeries Correctly
Whether for cosmetic or therapeutic purposes, these procedures can prove essential. Cin... Read more
Help the Slipper Fit by Coding Cinderella Surgeries Correctly
Whether for cosmetic or therapeutic purposes, these procedures can prove essential. Cin... Read more
Multiple Procedures:
Focus on Debridement Types Before Adding 59
Remember, anatomical area is not an issue for these services. When a physician perform... Read more
Focus on Debridement Types Before Adding 59
Remember, anatomical area is not an issue for these services. When a physician perform... Read more
News You Can Use:
Note New POS to Nail 'Off-Campus' Coding
Anticipate imminent changes in payment for off-campus provider-based clinics. As of Ja... Read more
Note New POS to Nail 'Off-Campus' Coding
Anticipate imminent changes in payment for off-campus provider-based clinics. As of Ja... Read more
Catastrophe/Disasters:
Prepare for the Worst with Modifier CR Smarts
President must make declaration before you can use modifier. While no one wants to thi... Read more
Prepare for the Worst with Modifier CR Smarts
President must make declaration before you can use modifier. While no one wants to thi... Read more
Diagnosis Coding:
Get Documentation Details Right to Nail Dx Codes
Make sure laterality, anatomy are marked in codes if necessary. A big part of diagnosis c... Read more
Get Documentation Details Right to Nail Dx Codes
Make sure laterality, anatomy are marked in codes if necessary. A big part of diagnosis c... Read more
Artificial Intelligence:
Ask These Questions When Searching for an AI Coding System — Part 2
Will the price point deter future adopters? Last month, we examined some key questions me... Read more
Ask These Questions When Searching for an AI Coding System — Part 2
Will the price point deter future adopters? Last month, we examined some key questions me... Read more
Modifier Madness:
Append Assistant at Surgery Modifiers Correctly
Hint: Do not report modifiers 80 and AS together. Modifiers are important to your medical... Read more
Append Assistant at Surgery Modifiers Correctly
Hint: Do not report modifiers 80 and AS together. Modifiers are important to your medical... Read more
Surgery:
Know Area Before Coding Neurostimulator Arrays
A trio of code sets represents these surgeries. Patients requiring open neurostimulator e... Read more
Know Area Before Coding Neurostimulator Arrays
A trio of code sets represents these surgeries. Patients requiring open neurostimulator e... Read more
Medicare Physician Fee Schedule:
Here’s the Big News in the 2025 Proposed Rule
Big surprise: Another rate cut is coming. The Centers for Medicare & Medicaid Servic... Read more
Here’s the Big News in the 2025 Proposed Rule
Big surprise: Another rate cut is coming. The Centers for Medicare & Medicaid Servic... Read more
Modifier Madness:
Append Assistant at Surgery Modifiers Correctly
Hint: Do not report modifiers 80 and AS together. Modifiers are important to your medica... Read more
Append Assistant at Surgery Modifiers Correctly
Hint: Do not report modifiers 80 and AS together. Modifiers are important to your medica... Read more
Item Focus:
M1340: Use 6 Pointers To Know which Wounds Make the Surgical Wounds Cut
Hint: Look to the OASIS Q&As when you’re stuck with this item. It’s no... Read more
M1340: Use 6 Pointers To Know which Wounds Make the Surgical Wounds Cut
Hint: Look to the OASIS Q&As when you’re stuck with this item. It’s no... Read more
Tool:
Answer Common M1340 Questions with this Chart
Stay up-to-date for greatest accuracy. OASIS item M1340 — Does this patient have... Read more
Answer Common M1340 Questions with this Chart
Stay up-to-date for greatest accuracy. OASIS item M1340 — Does this patient have... Read more
OASIS-C1:
Prepare to Move Forward with OASIS-C1
New assessment form will go into effect before ICD-10. If you’ve been looking fo... Read more
Prepare to Move Forward with OASIS-C1
New assessment form will go into effect before ICD-10. If you’ve been looking fo... Read more
Obstetrics:
Tubal Ligation Claims: Here’s Why Some Payers May Still Balk at +58661
Is a tubal ligation bundled with a cesarean section? Find out. Have a tubal ligation clai... Read more
Tubal Ligation Claims: Here’s Why Some Payers May Still Balk at +58661
Is a tubal ligation bundled with a cesarean section? Find out. Have a tubal ligation clai... Read more
Gynecology:
Adhesiolysis Myths Debunked: You Can Sometimes Report it Separately
Here are the words your ob-gyn’s documentation needs to contain. Time and time again, ... Read more
Adhesiolysis Myths Debunked: You Can Sometimes Report it Separately
Here are the words your ob-gyn’s documentation needs to contain. Time and time again, ... Read more
News You Can Use:
Get Ready for Pertinent MPFS 2025 Updates
See how telehealth has evolved. The Centers for Medicare & Medicaid Services (CMS) ha... Read more
Get Ready for Pertinent MPFS 2025 Updates
See how telehealth has evolved. The Centers for Medicare & Medicaid Services (CMS) ha... Read more
ICD-10-CM Coding:
Solve the Active vs. Personal History Dx Coding Conundrum
Hint: Treatment documentation is key. One of the most common areas of confusion when it c... Read more
Solve the Active vs. Personal History Dx Coding Conundrum
Hint: Treatment documentation is key. One of the most common areas of confusion when it c... Read more
Remote Physiological Monitoring:
Know the Dos and Don’ts of RPM Coding
Hint: Time is money. As healthcare technology advances, more digital medicine services â€... Read more
Know the Dos and Don’ts of RPM Coding
Hint: Time is money. As healthcare technology advances, more digital medicine services â€... Read more
Practice Management:
Improve Provider, Coder, Biller Relations, Improve Outcomes and Revenue
Three different roles, the same shared goals. In her 2024 Regional HEALTHCON presentatio... Read more
Improve Provider, Coder, Biller Relations, Improve Outcomes and Revenue
Three different roles, the same shared goals. In her 2024 Regional HEALTHCON presentatio... Read more
CPT® 2025:
Get to Know the 2025 CPT® Revisions
Be prepared for a host of new telemedicine codes. It won’t take a lot for you to stay a... Read more
Get to Know the 2025 CPT® Revisions
Be prepared for a host of new telemedicine codes. It won’t take a lot for you to stay a... Read more
E/M Coding:
Let These 3 Tips Lead You to New vs. Established Patient Clarity
You can collect more for new patients — but check these guidelines first. What’s the ... Read more
Let These 3 Tips Lead You to New vs. Established Patient Clarity
You can collect more for new patients — but check these guidelines first. What’s the ... Read more
Practice Management:
Improve Provider, Coder, Biller Relations, Improve Outcomes and Revenue
Three different roles, the same shared goals. In her presentation “Documenting and Codi... Read more
Improve Provider, Coder, Biller Relations, Improve Outcomes and Revenue
Three different roles, the same shared goals. In her presentation “Documenting and Codi... Read more
Reimbursement:
8 Things Your Optometry Practice Must Know About MACRA & MIPS in 2017
Good news: 2017 is a ‘Get Out of Jail Free’ card. Confused about what the ... Read more
8 Things Your Optometry Practice Must Know About MACRA & MIPS in 2017
Good news: 2017 is a ‘Get Out of Jail Free’ card. Confused about what the ... Read more
Revenue Boost:
Is Your Practice's Optical Shop As Profitable As It Can Be?
This 6-question test says for sure. If you’re like most optometry practices, you... Read more
Is Your Practice's Optical Shop As Profitable As It Can Be?
This 6-question test says for sure. If you’re like most optometry practices, you... Read more
Revenue Boost:
Are Remakes Eating Away at Your Optical's Profits?
You don’t shell out for the cost of remakes immediately, but if you have a high re... Read more
Are Remakes Eating Away at Your Optical's Profits?
You don’t shell out for the cost of remakes immediately, but if you have a high re... Read more
CPT® Coding Strategies:
Perfect Your Dentoalveolar Excision Coding With These 3 Useful Tips
Hint: Don’t leave $240 on the table by failure to identify right type of repair. ... Read more
Perfect Your Dentoalveolar Excision Coding With These 3 Useful Tips
Hint: Don’t leave $240 on the table by failure to identify right type of repair. ... Read more
ICD-10 Coding:
Decide From Two Options When Reporting Diagnosis of Xerostomia
Hint: Don’t forget to report additional codes to identify alcohol or tobacco use. ... Read more
Decide From Two Options When Reporting Diagnosis of Xerostomia
Hint: Don’t forget to report additional codes to identify alcohol or tobacco use. ... Read more
Medicare News:
Be Informed About OIG's Takedown of Those Receiving Kickbacks
Latest technology and data analysis helps capture more than 300 offenders. If you are ... Read more
Be Informed About OIG's Takedown of Those Receiving Kickbacks
Latest technology and data analysis helps capture more than 300 offenders. If you are ... Read more
Surgery Spotlight:
Understand the Ins and Outs of UCL Repair
How well do you know the elbow anatomy? When the surgeon performs work on an ulnar collat... Read more
Understand the Ins and Outs of UCL Repair
How well do you know the elbow anatomy? When the surgeon performs work on an ulnar collat... Read more
Surgery Spotlight:
Help the Slipper Fit by Coding Cinderella Surgeries Correctly
Whether for cosmetic or therapeutic purposes, these procedures can prove essential. Cind... Read more
Help the Slipper Fit by Coding Cinderella Surgeries Correctly
Whether for cosmetic or therapeutic purposes, these procedures can prove essential. Cind... Read more
Modifier Madness:
Append Assistant at Surgery Modifiers Correctly
Hint: Do not report modifiers 80 and AS together. Modifiers are important to your medical... Read more
Append Assistant at Surgery Modifiers Correctly
Hint: Do not report modifiers 80 and AS together. Modifiers are important to your medical... Read more
ICD-10 Coding:
Take These 4 Tips, Go to the Head of the Neoplasm Table
Learn the right way to code metastatic cancers. If you’re new to coding cancers of the ... Read more
Take These 4 Tips, Go to the Head of the Neoplasm Table
Learn the right way to code metastatic cancers. If you’re new to coding cancers of the ... Read more
E/M Coding:
Let These 3 Tips Lead You to New vs. Established Patient Clarity
You can collect more for new patients — but check these guidelines first. What’s the ... Read more
Let These 3 Tips Lead You to New vs. Established Patient Clarity
You can collect more for new patients — but check these guidelines first. What’s the ... Read more
Documentation:
Address These Key Fields, Complete ABNs With Ease
Don’t forget that every ABN form must be one single page. As every otolaryngology prac... Read more
Address These Key Fields, Complete ABNs With Ease
Don’t forget that every ABN form must be one single page. As every otolaryngology prac... Read more
ICD-10-CM Coding:
Try Out These 2 Demanding ICD-10-CM Surgical Setting Scenarios
Use all guidelines at your disposal for post-surgical complications Getting to the bottom... Read more
Try Out These 2 Demanding ICD-10-CM Surgical Setting Scenarios
Use all guidelines at your disposal for post-surgical complications Getting to the bottom... Read more
Modifiers:
Learn The Ropes of Modifier 53 Coding for Terminated Biopsies
Consider a number of variables, including use of CT guidance. Biopsy coding can become a ... Read more
Learn The Ropes of Modifier 53 Coding for Terminated Biopsies
Consider a number of variables, including use of CT guidance. Biopsy coding can become a ... Read more
CPT® Coding:
Get Answers to 4 Pertinent Skin Biopsy Questions
Use these FAQs as a reference for your future skin biopsy claims. Any general surgery cod... Read more
Get Answers to 4 Pertinent Skin Biopsy Questions
Use these FAQs as a reference for your future skin biopsy claims. Any general surgery cod... Read more
Interventional PM:
Put Nerve Blocks, Pain Pumps on PM List
There are several types of nerve blocks for interventional PM. Patients reporting to the ... Read more
Put Nerve Blocks, Pain Pumps on PM List
There are several types of nerve blocks for interventional PM. Patients reporting to the ... Read more
Q&A:
Get Your Incident-to Pay While You Still Can
When 2020 ends, so might incident-to. While incident-to might be on its way out, the bill... Read more
Get Your Incident-to Pay While You Still Can
When 2020 ends, so might incident-to. While incident-to might be on its way out, the bill... Read more
Compliance:
Feds Primed to Find Fraud in Opioid Prescribing
Get all your procedures in place to prevent trouble. As 2020 kicks off, PM practices find... Read more
Feds Primed to Find Fraud in Opioid Prescribing
Get all your procedures in place to prevent trouble. As 2020 kicks off, PM practices find... Read more
E/M Coding:
Heed This Expert Insight to Correctly Code for Time
Compare these auditor red flags with your practice’s processes. Even for the most seaso... Read more
Heed This Expert Insight to Correctly Code for Time
Compare these auditor red flags with your practice’s processes. Even for the most seaso... Read more
Revenue Booster:
Boost Your Health IT Checklist With These 10 Resources
See how each agency factors into the HIT equation. Navigating the regulatory waters of h... Read more
Boost Your Health IT Checklist With These 10 Resources
See how each agency factors into the HIT equation. Navigating the regulatory waters of h... Read more
Part B Coding Coach:
Ease the Suffering With This Low Back Pain Coding Primer
Hint: Review ICD-10 guidance on coding back injuries. If you find coding low back pain ch... Read more
Ease the Suffering With This Low Back Pain Coding Primer
Hint: Review ICD-10 guidance on coding back injuries. If you find coding low back pain ch... Read more
CPT® 2025:
Be Ready for Revised Genomic Sequence Codes, Updated HPV Options, and More
Know where to find resequenced codes in CPT® 2025. The official 2025 CPT® code set is o... Read more
Be Ready for Revised Genomic Sequence Codes, Updated HPV Options, and More
Know where to find resequenced codes in CPT® 2025. The official 2025 CPT® code set is o... Read more
ICD-10-CM Coding:
4 Tips Will Put You at the Head of the Neoplasm Table
Learn the right way to code metastatic cancers. If you’re new to coding neoplasms, the ... Read more
4 Tips Will Put You at the Head of the Neoplasm Table
Learn the right way to code metastatic cancers. If you’re new to coding neoplasms, the ... Read more
HIPAA:
Examine These 3 Cases, Stay Safe from HIPAA Violations
Avoid the fate of these healthcare entities with solid training and compliance strategies... Read more
Examine These 3 Cases, Stay Safe from HIPAA Violations
Avoid the fate of these healthcare entities with solid training and compliance strategies... Read more
News You Can Use:
Get to Know the 2025 ICD-10-CM Code Set
See how obesity coding is getting more precise. With more than 250 new diagnosis codes, t... Read more
Get to Know the 2025 ICD-10-CM Code Set
See how obesity coding is getting more precise. With more than 250 new diagnosis codes, t... Read more
Telehealth:
Keep Up With These Changes to Post PHE Telehealth
And get ready for telehealth codes to change again in 2025. During her HEALTHCON 2024 pr... Read more
Keep Up With These Changes to Post PHE Telehealth
And get ready for telehealth codes to change again in 2025. During her HEALTHCON 2024 pr... Read more
Practice Management:
Boost Financial Literacy with This Expert Advice
Hint: Make sure you involve physicians, so they understand the ripples of their work. Ma... Read more
Boost Financial Literacy with This Expert Advice
Hint: Make sure you involve physicians, so they understand the ripples of their work. Ma... Read more
Fracture Coding and Casts:
Facilitate These Coding and Casting Tips for Fractures
Beware: E/M codes are not always billable. When a patient comes in with a broken ankle, y... Read more
Facilitate These Coding and Casting Tips for Fractures
Beware: E/M codes are not always billable. When a patient comes in with a broken ankle, y... Read more
Compliance:
Understand the 5 Challenges Remote Workers Face
Craft effective policies to maintain compliance. Remote workers face several challenges... Read more
Understand the 5 Challenges Remote Workers Face
Craft effective policies to maintain compliance. Remote workers face several challenges... Read more
Practice Management:
Improve Provider, Coder, Biller Relations, Improve Outcomes and Revenue
Three different roles, the same shared goals. In her presentation “Documenting and Co... Read more
Improve Provider, Coder, Biller Relations, Improve Outcomes and Revenue
Three different roles, the same shared goals. In her presentation “Documenting and Co... Read more
Revenue:
Improve Provider, Coder, Biller Relations, Improve Outcomes and Revenue
Three different roles, the same shared goals. In her HEALTHCON Regional presentation “D... Read more
Improve Provider, Coder, Biller Relations, Improve Outcomes and Revenue
Three different roles, the same shared goals. In her HEALTHCON Regional presentation “D... Read more
Coding:
Let These 3 Tips Lead You to New vs. Established Patient Clarity
You can collect more for new patients — but check these guidelines first. What’s the ... Read more
Let These 3 Tips Lead You to New vs. Established Patient Clarity
You can collect more for new patients — but check these guidelines first. What’s the ... Read more
Staffing:
Understand the 5 Challenges Remote Workers Face
Craft effective policies to maintain compliance. Remote workers face several challenges ... Read more
Understand the 5 Challenges Remote Workers Face
Craft effective policies to maintain compliance. Remote workers face several challenges ... Read more
Case Study Corner:
Correctly Code These RSV Bronchiolitis Cases
Also: review the RSV testing codes. One of the most common diagnoses that primary care pr... Read more
Correctly Code These RSV Bronchiolitis Cases
Also: review the RSV testing codes. One of the most common diagnoses that primary care pr... Read more
News You Can Use:
Get to Know the 2025 ICD-10 Code Set
Specify obesity classes with new codes. With more than 250 new diagnosis codes, the 2025 ... Read more
Get to Know the 2025 ICD-10 Code Set
Specify obesity classes with new codes. With more than 250 new diagnosis codes, the 2025 ... Read more
Practice Management:
Find 7 Myths and 1 Truth About Fee-for-Time Billing
Prep now for holiday fee-for-time fill-ins. Everyone needs a vacation, and primary care ... Read more
Find 7 Myths and 1 Truth About Fee-for-Time Billing
Prep now for holiday fee-for-time fill-ins. Everyone needs a vacation, and primary care ... Read more
CPT® 2017:
Alter Your Psychotherapy Reporting Skills in 2017 Using These 3 Scenarios
Hint: Check CCI when reporting family therapy with individual therapy. As you get read... Read more
Alter Your Psychotherapy Reporting Skills in 2017 Using These 3 Scenarios
Hint: Check CCI when reporting family therapy with individual therapy. As you get read... Read more
CPT® Coding:
Get Set to Refresh Family Therapy Reporting Beginning New Year
Hint: Report family codes only if time component is satisfied. As you make way for CPT... Read more
Get Set to Refresh Family Therapy Reporting Beginning New Year
Hint: Report family codes only if time component is satisfied. As you make way for CPT... Read more
Collections:
Understand the Do's and Don'ts for Handling Nonpaying Patients
Try ‘hard’ collection as your last option. You might be familiar with situ... Read more
Understand the Do's and Don'ts for Handling Nonpaying Patients
Try ‘hard’ collection as your last option. You might be familiar with situ... Read more
ICD-10-CM:
Learn 5 Tips to Elevate Your COPD Coding
Hint: pay attention to the ICD-10-CM code notes. Chronic obstructive pulmonary disease (C... Read more
Learn 5 Tips to Elevate Your COPD Coding
Hint: pay attention to the ICD-10-CM code notes. Chronic obstructive pulmonary disease (C... Read more
Case Study:
Correctly Code These RSV Bronchiolitis Cases
Also: review the RSV testing codes. One of the most common diagnoses pulmonologists see d... Read more
Correctly Code These RSV Bronchiolitis Cases
Also: review the RSV testing codes. One of the most common diagnoses pulmonologists see d... Read more
Artificial Intelligence:
Ask These Questions When Searching for an AI Coding System – Part 1
Can NLP decipher language differences between doctors? Choosing the right artificial int... Read more
Ask These Questions When Searching for an AI Coding System – Part 1
Can NLP decipher language differences between doctors? Choosing the right artificial int... Read more
CPT® 2025:
Report MR Exam Implant Prep With 2025 CPT® Codes
Pay careful attention to the new guidelines. On Sept. 10, 2024, the AMA released the 2025... Read more
Report MR Exam Implant Prep With 2025 CPT® Codes
Pay careful attention to the new guidelines. On Sept. 10, 2024, the AMA released the 2025... Read more
Practice Management:
Use This Guidance to Improve Your Coding Education Process
Check out these tips for more effective clinician communication. Coding education is an o... Read more
Use This Guidance to Improve Your Coding Education Process
Check out these tips for more effective clinician communication. Coding education is an o... Read more
Artificial Intelligence:
Ask These Questions When Searching for an AI Coding System – Part 2
Will the price point deter future adopters? Last month, Radiology Coding Alert examined s... Read more
Ask These Questions When Searching for an AI Coding System – Part 2
Will the price point deter future adopters? Last month, Radiology Coding Alert examined s... Read more
Cybersecurity:
Discover 3 Passwordless Authentication Methods for Your Practice
Find out if biometrics and separate keys are the wave of the future. Clinicians have full... Read more
Discover 3 Passwordless Authentication Methods for Your Practice
Find out if biometrics and separate keys are the wave of the future. Clinicians have full... Read more
Telehealth:
Keep Up With These Changes to Post PHE Telehealth
And get ready for telehealth codes to change again in 2025. During her HEALTHCON 2024 pr... Read more
Keep Up With These Changes to Post PHE Telehealth
And get ready for telehealth codes to change again in 2025. During her HEALTHCON 2024 pr... Read more
Best Practices:
Dissect Your Workflow to Streamline Operations
Hint: Patient satisfaction is all about setting expectations. In a medical practice, ord... Read more
Dissect Your Workflow to Streamline Operations
Hint: Patient satisfaction is all about setting expectations. In a medical practice, ord... Read more
Frequently Asked Questions:
Check Your Urinary Diversion Knowledge With These FAQs
Remember to append modifier 50 where necessary to avoid a denial. There are instances wh... Read more
Check Your Urinary Diversion Knowledge With These FAQs
Remember to append modifier 50 where necessary to avoid a denial. There are instances wh... Read more
CPT®:
Decipher the Symbols in Your CPT® Code Book for Easier Code Selection
These notations can help coders better master each code’s guidelines and descriptors. ... Read more
Decipher the Symbols in Your CPT® Code Book for Easier Code Selection
These notations can help coders better master each code’s guidelines and descriptors. ... Read more
Practice Management:
Study These Strategies for Setting Up a Solid CDI Process
Understand the benefits of regular self-audits. Comprehensive clinical documentation is... Read more
Study These Strategies for Setting Up a Solid CDI Process
Understand the benefits of regular self-audits. Comprehensive clinical documentation is... Read more
Dec 04, 2025
Otolaryngology Coding:Defer to Provider for Otitis Media Timeline Guidance
Question: My otolaryngologist documented otitis media with effusion for one patient a... Read more
Dec 04, 2025
Emergency Department Coding:Differentiate Modifiers 25 and 57 to Stay Compliant
The key for ED providers is to count the global days. When your emergency department (ED)... Read more
Dec 04, 2025
Technology & Innovation:Avoid Doubling Your Workload by Using Coding-Aware AI
Question: What’s the difference between coding-naive and coding-aware artificial intelli... Read more
Nov 28, 2025
General Coding:Find Clarity in Wound Care Coding
Here’s what you need to know regarding diagnosis documentation and reporting for wound c... Read more
Nov 28, 2025
Neurosurgery Coding:Know Vertebroplasty/Kyphoplasty Differences for Correct Coding
Affected bone being elevated? That’s a kyphoplasty. Kyphoplasty and vertebroplasty are ... Read more
Nov 28, 2025
Optometry/Ophthalmology Coding:Get to Know Uveitis and How to Code the Diagnosis
Question: I’m new to ophthalmology coding and have an encounter note where the physician... Read more
Oct 31, 2025
Cardiology Coding:Here’s What You Need to Know About Watchman Procedures
Find out which condition’s symptoms the Watchman device tries to mitigate. When you hea... Read more
Oct 31, 2025
Compliance Coding:Don’t Let Vendors Become a Compliance Weak Spot
Do your due diligence on vendor trustworthiness before signing any contracts. Many practi... Read more
Oct 31, 2025
Path/Lab Coding:Take This Advice to Select the Correct Tonsil Biopsy Code
Question: Can you explain the difference between 88304, 88305, and 88309 with regard to to... Read more
Sep 30, 2025
Optometry/Ophthalmology Coding:Keep Your Strabismus Diagnosis Coding From Getting Crossed Up
Learn the difference between hypertropia and hypotropia. Strabismus, commonly known as cr... Read more
Sep 30, 2025
Anesthesia Coding:Rely on These Codes for Obstetric Anesthesia Services
There are 4 core and 2 add-on codes to remember. Anesthesia providers play a crucial role... Read more
Sep 30, 2025
Anesthesia Coding:Aim for Specificity for Coding Anesthesia During Lithotripsy
Question: Which CPT® codes might be appropriate for reporting anesthesia services perform... Read more
Aug 29, 2025
Pediatric Coding:Smooth Over These Common Skin Conditions
Know payer policies to prevent issues with cosmetic procedure coverage. Recent studies ha... Read more
Aug 29, 2025
Orthopedic Coding:Analyze Arthroscopic Shoulder Surgical Procedure Coding Rules
Don’t report 2 codes when only 1 is needed. Orthopedic procedures on the shoulder can b... Read more
Aug 29, 2025
ICD-10-CM Coding:Be Agile When Coding Conditions That Might Require PT
One code in ICD-10-CM may be useful to describe several different conditions. If you see ... Read more
Jul 31, 2025
Anesthesia Coding:Check With Payers for Modifier 51 Specifics
Question: Can I use modifier 51 on secondary or other additional post-op pain blocks? Del... Read more
Jul 31, 2025
Optometry/Ophthalmology Coding:Identify Inflammatory Sclera Conditions for Your Claim
Don’t forget to specify laterality with a 6th character. The eye is made up of several ... Read more
Jul 31, 2025
General Surgery Coding:Examine These 5 Skin Biopsy Myths
Learn how to bill multiple biopsies with different techniques. Skin biopsies are simple p... Read more
Jun 30, 2025
ED Coding:Use These Z Codes Primarily as Primary Diagnoses
Question: I have a rather odd claim in front of me. We are a small hospital in a very rura... Read more
Jun 30, 2025
Oncology Coding:Use This Train of Thought for Coding Monoclonal Antibody Drug Administration
Question: Our team is discussing how to validate the administration code (chemo or non-che... Read more
Jun 30, 2025
Path/Lab Coding:Learn This Lyme Test Lesson
Question: We are currently seeing a greater than normal amount of requests to conduct lab ... Read more
May 30, 2025
Technology & Innovation:Explore How AI Can Take Items Off Your To-Do List
Jump start your projects with AI analyzing the data. Have you ever wondered how much time... Read more
May 30, 2025
Neurology & Pain Management Coding:Know Differences Before Coding Extremity Ultrasounds
Question: What is the difference between a complete and a limited ultrasound (US) of an ex... Read more
May 30, 2025
Pulmonology Coding:Use This Guide to Accurately Code Pulmonary Embolism Diagnoses
Receive a PE condition breakdown. Pulmonary embolism (PE) is a life-threatening condition... Read more
Apr 30, 2025
In Case You Missed It (RCI Bonus Content):Know How to Code Surgical Teams Correctly
Know when to use the co-surgeon, assistant-at-surgery, and surgical team modifiers. Over ... Read more
Apr 30, 2025
Otolaryngology Coding:Take This Advice for Foolproof Rhinoplasty Claims
Let these 2 Medicare LCDs be your guides. If your otolaryngologist performs a rhinoplasty... Read more
Apr 30, 2025
General Surgery Coding:Test Your Knowledge of Colorectal Procedure Coding
Query the provider before choosing an unspecified code. It’s essential to thoroughly ex... Read more
Mar 31, 2025
Diagnostic Radiology Coding:Use This Guide to Identify Venous Malformation Imaging and Dx Codes
Remember to examine MRI code descriptors. When abnormalities develop in the body’s vasc... Read more
Mar 31, 2025
Gastroenterology Coding:Master Same-Day GI Endoscopy Coding With 5 Key Scenarios
Hint: Mind your modifiers to ensure accurate coding and compliance. Gastroenterologists a... Read more
Mar 31, 2025
Diagnostic Radiology Coding:Remember a 7th Character When Reporting Gout Dx
Question: I have a radiology report where the radiologist performed a CT scan of the patie... Read more
Feb 28, 2025
Neurosurgery Coding:Zone in on Key Points to Alleviate the Pain of Arthrodesis Surgery Coding
You’ll filter through complex documentation on these claims. When choosing an appropria... Read more
Feb 28, 2025
Optometry/Ophthalmology Coding:Don’t Miss Out on Reimbursement by Skipping Eye Exam Codes
Question: I work for an ophthalmologist who also has a retina subspecialty. The provider w... Read more
Feb 28, 2025
Pulmonology Coding:Know When to Separately Report Spirometry Results Interpretation
Question: A pulmonologist in our practice interpreted the results of a spirometry test per... Read more
Jan 31, 2025
Orthopedic Coding:Understand the Complexities of Shoulder Arthroplasty Coding
Know when to report arthroplasty revisions. Patients experiencing pain and stiffness in t... Read more
Jan 31, 2025
Urology Coding:Code Incontinence Claims With Confidence
Add all relevant codes linked to the diagnosis to avoid denials. Coders must be meticulou... Read more
Jan 31, 2025
Pulmonology Coding:Prevent a Surfactant Administration Coding Collapse
Can you report 94610 with critical care codes? Find out. Babies who are born prematurely ... Read more
Dec 31, 2024
Oncology Coding:Define the Difference Between Diagnostic Bone Marrow Procedures
Question: When I read an op note for a bone marrow procedure, I’m confused about th... Read more
Dec 31, 2024
ICD-10-CM Coding:Don’t Bang Your Head in Frustration Over This Headbanging
Question: I’m reading encounter notes for a patient who presented with neck pain af... Read more
Dec 31, 2024
General Coding:Explore +G2211 Usage Past and Yet to Come
Hint: Going forward, modifier 25 can be in play. The road to reimbursement for services p... Read more