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Latest articles

Emergency Department - APC Reimbursement Method
September 15th, 2022 - Christine Woolstenhulme, CPC, CMRS, QCC, QMCS
CMS pays emergency department visits through a payment method using Ambulatory Payment Classifications (APCs). Most payers also use the APC reimbursement system; however, there may be some differences in payer policies (always review your specific payer policy). APCs are the primary type of payment made under the OPPS, comprising groupings ...
Why Medical Coding and Billing Software Desperately Needs AI
September 7th, 2022 - Find-A-Code
It has been said that the healthcare industry is notoriously slow in terms of technology adoption. One need only look at how convoluted medical coding and billing are to know that it needs a technology injection. Specifically, medical coding and billing software desperately needs artificial intelligence (AI).
CMS says Less Paperwork for DME Suppliers after Jan 2023!
August 18th, 2022 - Christine Woolstenhulme, QCC, QMCS, CPC, CMRS
Attention providers, suppliers, billers, and vendors who bill Durable Medical Equipment (DME) to Medicare!  Currently, a supplier receives a signed Certificate of Medical Necessity (CMN) from the treating physician or creates and signs a DME Information Form (DIFs); these are required to be sent with the claim. However, this is about ...
Things to Consider Before Upgrading Medical Billing Software
August 11th, 2022 - Find-A-Code
Your practice has utilized the same medical billing software for years. The medical billing staff says it is time for a change. You don't necessarily disagree, but you also don't know where to begin your search for new software. There are so many vendors offering so many products that making sense of it all can be challenging.
Calendar Year 2023 Medicare Advantage and Part C & D Payment Policies
August 9th, 2022 - Aimee L. Wilcox, CPMA, CCS-P, CST, MA, MT
Each year CMS publishes an Advance Notice of the upcoming years Medicare Advantage (MA) Capitation Rates and Part C and Part D Payment Policies and asks for comments related to it. Each of the comments are carefully reviewed and responded to and often are impactful to changes seen between the Advance Notice and final publication referred to as the Rate Announcement. With health equity as a primary focus for 2023, CMS announced some policy changes that may impact your organization.

Editors choice articles

PCS Coding for Ankle Fracture - Look Deeper Into the Codes!
May 25th, 2021 - Christine Woolstenhulme, QCC, QMCS, CPC, CMRS
Coding Lesions and Soft Tissue Excisions
April 29th, 2021 - Christine Woolstenhulme, QCC, QMCS, CPC, CMRS
COVID-19 Vaccines
March 10th, 2021 - Christine Woolstenhulme, QCC, QMCS, CPC, CMRS
Not Following the Rules Costs Chiropractor $5 Million
September 1st, 2020 - Wyn Staheli, Director of Research
Is COVID-19 Causing Risk Adjustment “Gotcha’s”?
August 27th, 2020 - Wyn Staheli, Director of Research

Latest questions/posts

Breast reconstruction CPT codes
1st    Sep 16th, 2022 - Ellie

Esophagectomy with prophy Thoracic Duct Ligation
1st    Sep 1st, 2022 - aolsen7777

EGD with biopsy and botox injection
   Aug 27th, 2022 - Mabel

Adjacent Tissue Transfer with 2 surgeons
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Icd 10 code
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2008 Diagnosis Code?
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43264 and 43275
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Cerner/Soarian User Manual?
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   May 27th, 2022 - sharris

billing amounts
   May 22nd, 2022 - nia 4 

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Ccm billing
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Billing/Claims for 4 providers
1st    Apr 14th, 2022 - billing81 1 

Claim Billing question
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Ercp codes
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maximum limit on units claimed
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Anesthesia for Colonoscopy/ EGD
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Emergency department 99282 what is included
1st    Feb 18th, 2022 - MFC

   Feb 18th, 2022 - surgicalcoder65 2 

Can someone tell me what the cpt code is for Bilateral segmental tubal excision and ligation by endoscopy?
1st    Feb 15th, 2022 - CCShaw

1st    Jan 14th, 2022 - yd


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