Modern medical billing activities are complex, and it may take months to process a bill.  Most issues crop up from internal workflow with demands forced by claims processing sellers as well as external clearinghouses. The overall process needs continuous evaluation...

Utilization review teams and physician advisors have the same goal as the Centers for Medicare & Medicaid Services (CMS): correct status for all patients. But getting a Medicare inpatient into the correct status creates an admin..

It has now been over 18 months since the Centers for Medicare & Medicaid Services (CMS) updated the discharge planning conditions of participation, but we still have no interpretive guidelines. I am sure that the pandemic has affected..

OSHA has issued an Emergency Temporary Standard (ETS) for occupational exposure to COVID-19 that is applicable only to healthcare employers. The genesis for this ETS came one day after President Biden’s inauguration when, on January...

Recently I was listening to a podcast called Coder vs. CDI by my friend, Allen Frady, and his co-host, Amy Czahor, about how to code mild COVID-19 with other conditions; at one point, Allen mentioned he wanted to hear opinions from doctors. So here’s my opinion...

Refinements continue for the evaluation and management (E/M) office-visit and outpatient documentation and coding reforms that took effect this year, and these include technical corrections updates to the CPT^® code set published by the AMA that add clarity and answer...