As reported by the American Hospital Association and other organizations, starting in 2020, the Centers for Medicare & Medicaid Services (CMS) will be adding outpatient total knee arthroplasty (TKA) to the list of episodes in the Bundled Payment for Care Improvement (BPCI) advanced program.

Not all individuals have the same illnesses, and even for the same chronic diseases, how any patient is affected varies. In determining payments for care, Medicare introduced modifiers to gauge and report on the associated severity of illness. Often, the chicanery...

Are you getting enough sleep? So often we sacrifice sleep for work, housework, family demands, or watching that good movie or basketball game. Sleep is just as important as a healthy diet and regular physical activity. Poor sleep habits can lead to an increased...

Q: Are there any updates on the Evaluation and Management (E/M) code requirements?

A: The American Medical Association (AMA) has now weighed in with their E/M requirement modifications, which means that all payers will be...

The clock is ticking, and you’re trying to select the right E/M level from a drop-down menu in the EHR. Choose a level that’s too high, and you run the risk of post-payment audits and recoupments. Choose one that’s too low, and you may lose revenue to which you’re entitled.

For those who somehow missed it, there are 88 current ICD-10-CM Z codes and subcategories that encompass psychosocial and socioeconomic circumstances: Z55-65. One of these codes is Z59: Problems related to housing and economic circumstances. These Z codes have been part...