While preparing for a clinical validation presentation on acute kidney injury denials, I took inventory of the most common denials and recoveries obtained by payers. It came as no surprise that sepsis, severe malnutrition..

It’s that time of year again when everyone is planning ways to make the upcoming year their best year yet. If your practice is like most other practices, then one area where you could use some work is billing and collections.

Provider groups are concerned that some proposals in the Medicare Physician Fee Schedule rule for 2021 would exacerbate the financial challenges physicians are already facing during the COVID-19 pandemic, including lack of adequate telehealth reimbursement and sustainable practice revenue.

Throughout the history of international diagnostic coding systems, including the International Classification of Diseases (ICD), pain diagnoses have never been represented systematically. The lack of a coding structure for chronic pain conditions has made it difficult for...

While some have said medical coding sits quietly in the middle of the healthcare revenue cycle, it is a key step that, when done inadequately, can impact each part of the revenue cycle after it. Medical coding quality is crucial...

Becker's ASC Review compiled a timeline of significant medical coding updates that have been proposed or implemented so far this year:

As we enter the final quarter of 2020, I hope everyone is committed to being prepared for the 2021 evaluation and management (E&M) changes, because they’re locked in, and the focus going forward should be on education for coders, auditors, and providers.

Federal healthcare audits have resumed, and they are not limited to durable medical equipment (DME) or any one specific group of providers, any one type of contractor, or any one specific...