Problem-oriented E&M services, office, and other outpatient visit codes 99202-99215 (along with hospital, observation, and consultative encounters) are for patients who present with signs, symptoms, conditions, diagnoses and/or problems that need to be “addressed” by a physician or qualified healthcare professional, and the reason for the encounter is usually documented using the patient’s own words.

You might know that medical billing is a challenging process. That’s the reason why many people make several mistakes in this case. If you have the same problem, you can reduce errors by following the right steps.

In a recent study posted to the medRxiv* preprint server, researchers evaluated the use of U09.9, an International Classification of Diseases, Tenth Revision, Clinical Modification (ICD-10-CM) code described as ‘Post coronavirus disease 2019 (COVID-19) condition, unspecified’ for post-acute COVID-19 sequelae (long COVID).

CMS has released its Hospital Inpatient Prospective Payment System (IPPS) proposed rule for fiscal year 2023, which includes a payment rate boost for general acute care hospitals and new measures focused on health equity for the Hospital Inpatient Quality Reporting (IQR) program.

As we know, with the growth of outpatient surgical centers, advances in medical technology, and the shift of payers’ understanding in what they will consider to be an inpatient episode of care have all impacted the hospital patient composition.

The average cost of debunking a denial is $25 per claim, not to mention the continuous challenges associated with attaining timely payment. Reviewing denial management strategies on a regular basis may prove a more efficient payment journey.