Outpatient visits are being billed at higher levels, leading to increased healthcare spending and concerns about upcoding, a Peterson-KFF Health System Tracker found. Healthcare providers can bill outpatient evaluation and management (E/M) claims at five different levels...

Following a recent US District Court ruling on the federal government’s arbitration process for disputed medical billing—making the protocol for issuing decisions on disputed claims unclear—CMS posted some clarifying guidance on processing payment determinations to providers...

Current Procedural Terminology (CPT®) codes provide a uniform nomenclature for coding medical procedures and services that are critical to the communication between multiple stakeholders about the care patients receive. They can also be used to promote health equity.

February may be American Heart Month, but correctly diagnosing and coding cardiac conditions is something healthcare professionals need to work hard to get right 365 days a year. It’s a tenet being repeatedly reinforced by a myriad of articles and broadcast segments appearing...

One way to assess creativity in medicine is to look at how physicians are incorporating technology such as telehealth, virtual reality (VR) and augmented intelligence (AI), often called artificial intelligence, into their practices.

CMS proposes new rules for 2024 that apply to Medicare Advantage Plans. Last month, I told you that there would be big news coming, and sure enough, there was. The Centers for Medicare & Medicaid Services (CMS) proposed a new rule, to become effective in 2024, that would...