How Implementing a Career Ladder Improves Coder Accuracy

Published: Sat, 09/15/18

When Donella J. Lubelczyk, RN, BSN, ACM-RN, CRC, CRCR, entered her job as director of revenue cycle at Catholic Medical Center in Manchester, New Hampshire, she got a surprise when she visited the coders. They were spending a lot of time on Google and YouTube researching procedures, turning to search engines to look up information such as...

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Facilities Urged to Strengthen Coding Compliance Program

Recently in healthcare news were articles about two legal actions that cause one to reflect on the need for a strong (or stronger) coding and clinical documentation improvement (CDI) compliance programs. The first legal action cited the False Claims Act (FCA) and possible “upcoding” at...

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Providers Oppose Collapsing Medicare Reimbursement for E and M Visits

Providers are calling on CMS to not finalize a proposal to collapse Medicare reimbursement for evaluation and management (E/M) visits into a single, blended payment rate for E/M Levels 2 through 5 visits. In a recently proposed rule for the 2019 Medicare Physician Fee Schedule, CMS proposed the Medicare reimbursement change for...

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AMA Releases 2019 CPT® Code Set

The new current procedural terminology (CPT®) codes have been released with 335 code changes in 2019. There were many code revisions with guideline, description and instructional note changes. Let’s look at the highlights of many new CPT codes for 2019.

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AMA Adds Connected Health CPT Codes, Pushes for Medicare Payment

The American Medical Association (AMA) updated the Current Procedural Terminology (CPT) code set in 2019 to include new codes for connected health services in an effort to encourage CMS to pay for the services. The 2019 CPT code set contains 335 code changes that will go into effect for medical billing and coding on...

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