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ASC Coding, Billing, and Collections

ASC Coding, Billing, and Collections-News and Analysis

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Tags: documentation | modifier -59 | modifier -73 | modifier -74 | modifier -77 | modifiers | operative note | surgery centers

How often have you heard this phrase, "If it wasn't documented, it wasn't done?" The first concept I convey to physicians is that each specific medical record is unique in its own way and must withstand legal questioning. The medical record is used to create an infrastructure that supplies the necessary personnel with imperative information to deliver the best patient care. Legible and accurate documentation within the patient's medical record is an essential step in supplying vital information. Communication between physicians is also driven by the patient's medical record. Without readable documentation, the patient's health can be in jeopardy. The physician has an opportunity to increase revenue through educational sessions regarding "best practice documentation." Click to continue »  

Tags: cardiology | coding | denied claims | documentation | gastroenterology | specialty lines

Perhaps no process has as great an impact on a hospital's revenue cycle as procedure documentation and coding. When done accurately and efficiently, it can accelerate the billing cycle, reduce rejected or returned claims and increase revenues. Click to continue »  

Tags: antitrust | Blue Cross-Michigan | DOJ | insurance | Physicians Health Plan

Blue Cross Blue Shield of Michigan's subsidiary, Blue Care Networks of Michigan, abandoned its attempt to purchase Physicians Health Plan of Mid-Michigan after the Department of Justice informed the companies that it would file an antitrust lawsuit to block the acquisition, according to a DOJ news release. Click to continue »  

Tags: CMS | CPT 99499 | E/M codes | physician consultation codes

The Centers for Medicare and Medicaid Services released a series of questions and answers related to the recently eliminated physician consultation CPT codes, which address how evaluation and management services should be reported to CMS. Click to continue »  

Tags: Anthem | Connecticut | HHS | most favored clauses

Connecticut's Attorney General Richard Blumenthal notified Department of Health and Human Services Secretary Kathleen Sebelius of "most-favored nation" clauses included in many Anthem Blue Cross & Blue Shield contracts in his state, according to a report in the Hartford Courant. Click to continue »  

Tags: California | cuts | Medi-Cal | reimbursements

A federal appeals court has stopped the State of California from cutting Medi-Cal payments to physicians and hospitals by 5 percent, according to a report by the San Francisco Chronicle. Click to continue »  

Tags: coding | coding updates | Compliance Coding Management | erratas | IOLs

CPT copyright 2009 American Medical Association. All rights reserved. CPT is a registered trademark of the American Medical Association.

Diligent ASC coders always make sure they have the most current information from manuals, coding software, Medicare edits and the like. But sometimes they forget to check for updates that coding authorities issue during the year, such as Erratas, new Category III codes and monthly updates from CMS and the AMA. Click to continue »  

Tags: insurers | legislation | New Mexico | premiums

New Mexico insurers would be required to commit 85 percent of premiums toward actual healthcare services, under provisions of a bill passed by the state legislature, according to a story in New Mexico Business Weekly. Click to continue »  

Tags: Horizon BCBSNJ | modifier | modifier 25 | modifier 54 | modifier 55 | modifier 59 | modifier payment policy | New Jersey

Horizon Blue Cross Blue Shield of New Jersey will implement policy and procedural changes in regard to how services submitted with certain modifiers are reimbursed, effective May 17, according to a report by the American Academy of Professional Coders. Click to continue »  

Tags: AHRQ | coverage | government workers | health insurance

As hospitals and physicians offices become more involved in collecting charges from patients, it helps to understand how many have insurance policies, what their premiums are and what share of the premium they pay. Here the U.S. Agency for Healthcare Research and Quality (AHRQ) provides information on state and local government workers. Click to continue »  
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