The coding of medical diagnosis and treatment has always been a challenging issue. Translating a patient’s complex symptoms, and a clinician’s efforts to address them, into a clear and unambiguous classification code was difficult even in simpler times. Now...

Hospital billing departments coordinate health plan benefits every day. Typically, coordination of benefits (COB) is aided by patient registration workflows that gather basic demographic and health insurance information. But what if a patient gets hurt on the job or in an automobile accident?

Question: I am aware that diagnosis codes for 2020 updated Oct. 1, 2019, but what about CPT codes? And do you have any information about codes that may affect acupuncture providers?

The American Medical Association (AMA) recently issued a checklist for physician practices to use when adopting evaluation and management (E/M) coding and documentation changes slated to take effect next year.

Funding legislation aimed at keeping HHS and other non-Defense agencies running in fiscal year (FY) 2020 will also postpone $4 billion in Medicaid Disproportionate Share Hospital (DSH) payment cuts until May 20, 2020.

While many people make plans for a new year, it's also time to prepare for the new 2020 Current Procedural Terminology (CPT) codes. That means reviewing CPT coding changes, learning new codes, removing deleted codes, and understanding the revised codes and definitions.

On Oct. 9, the Centers for Medicare & Medicaid Services (CMS) issued a proposed rule to modernize and clarify the regulations that interpret the Medicare physician self-referral law (often called the “Stark Law”). The law prohibits physicians from making referrals for certain healthcare services...

As we get ready to say goodbye to another year of audits and investigations, compliance officers around the country have worked or are working to determine their audit elements for calendar year 2020, in response to the HHS and OIG 2020 Work...

We undertook this study because of concerns that Medicare Advantage organizations (MAOs) may use chart reviews to increase risk adjusted payments inappropriately. Unsupported risk adjusted payments are a major driver of improper payments in the...