CMS Says Post-Acute Care Choice Only Goes So Far

Published: Wed, 10/25/23

Link to all things medical coding & billing

CMS Says Post-Acute Care Choice Only Goes So Far

Access to post-acute care remains an issue in most hospitals around the country. Exacerbated by the staffing challenges that worsened during COVID-19, the ability to get a patient transferred to a skilled nursing facility (SNF) in a timely manner is rare. That creates several issues....

Staying Current with Medical Necessity

A new quarter began on Oct. 1, an event that usually brings updates to National Coverage Determinations (NCDs). The coding updates included for Oct. 1 are specified in Change Request (CR) 13166, which is a maintenance update. This document is mentioned in the MLN Connects published Sept. 28.

Asking clinicians to enhance their medical coding skills, another necessary task

Clinicians today are confronted with an increasing administrative burden alongside their patient care responsibilities, and a critical aspect of this burden is medical coding. This skill is crucial as it serves multiple purposes, including meeting billing standards affecting reimbursement, complying with quality...

Simplify E/M documentation and coding in your private practice

Often called the “language of medicine,” the CPT® code set is always evolving, and one reason for that evolution is to lower the administrative burden for physicians and their practices. Services involved in the E/M of a patient’s health are covered by CPT codes 99202–99499. These services were...

Why it’s Important to Understand Medicare and Medicaid Exclusions and Preclusions

In the post-public health emergency (PHE) era, I have noticed what I think may be a glitch in the computer system at the Centers for Medicare & Medicaid Services. Let me give you the facts, and you can decide whether it’s a glitch, human error, or a conspiracy against Medicare and Medicaid...

How Artificial Intelligence is Leveling the Playing Field for E&M Coding

It’s certainly not breaking news that artificial intelligence (AI) is making inroads in healthcare. Nearly every new article on the topic seems to describe how AI is doing the work that heretofore was being accomplished by humans: nurses, administrators, lab technicians, and coders.

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