On July 20, the Office of Inspector General (OIG) released a report that found that hospitals are overbilling or upcoding hospitals to the tune of $1 billion. OIG reviewed 200 claims made to Medicare that included a diagnosis of severe malnutrition and had a...

The attention given to total joint replacement has been a recurring headache for both physicians and hospitals over the last several years, and it appears that there is little chance of it abating. The latest is the announcement by RELI Group, a contractor for the Centers of Medicare and Medicaid Services (CMS), that an upcoming...

Claims denials can be frustrating for a physician practice to deal with, but leaving them unattended leaves a significant amount of revenue uncollected, says Andria Jacobs, RN, CPHQ, chief operating officer at PCG Software. Her company develops...

When a physician’s telehealth visit with a Medicare patient on FaceTime cut out after five minutes, they shifted to an audio-only visit, with the physician and patient speaking on the telephone. Although the call lasted for an hour, the physician didn’t document the time. That put her in a bind. To bill a time-based...

Podiatry coding is becoming increasingly complicated, and even the smallest reporting mistakes can lead to claim denials and reduced reimbursement. Worse, the stakes tend to escalate, with minor unchecked errors taking a major bite out of your bottom line.

Republican Gov. Brian Kemp signed legislation into law July 16 that aims to curb instances of surprise medical billing in Georgia. Three things to know:

The AMA Current Procedural Terminology (CPT^®) Editorial Panel has adopted a new CPT code to report antigen testing of patients suspected of SARS-CoV-2 infection.

The FY21 ICD-10-CM codes were released by the Center for Disease Control and Prevention (CDC) on July 1, 2020.  The new and updated diagnosis codes are another part of the preparation for FY21 which begins on October 1, 2020.

Getting paid requires accurate documentation and selecting the correct codes. In our Coding Case Studies, we will explore the correct coding for a specific condition based on a hypothetical clinical scenario. Check out the following scenario involving a patient presenting with asthma and see if you can choose the correct codes.

Telemedicine has become an indispensable part of clinical training during the COVID-19 pandemic, but care has to be taken to ensure both faculty and learners are set up to succeed in a new medium. An AMA webinar features guidance from physician experts on how to make the transition.