The Noridian iron infusion Local Coverage Determination (LCD) is important for just about everyone since Noridian is the Supplemental Medical Review Contractor (SMRC). Noridian could end up reviewing and denying your claims even if you’re not in Noridian’s Medicare Administrative Contractor (MAC) jurisdiction.

Q: Is reporting of Current Procedural Terminology (CPT) codes 99218-99220 restricted to a single physician?

A:  According to CPT guidelines, only the physician or non-physician practitioner (NPP) placing the patient in observation status (and subsequently discharging the patient) may report the appropriate initial observation code (99218, 99219, 99220)...

Artificial intelligence. The tech industry is just so enthusiastic for it and with good reason. As if the ability to process immense amounts of data wasn’t already good enough, the ability of AI to use this data and to learn from it in order to make subsequent interactions is nothing short of amazing.

The Centers for Medicare & Medicaid Services (CMS) recently published the 2020 Medicare Physician Fee Schedule (MPFS) Proposed Rule. While many issues are included in the 1,700-page rule, three are of particular importance to pediatrics: e-visits, emergency department (ED) visits and office visits.

Denials are a source of frustration for all physicians. When left unmanaged, they’re also one reason why physicians ultimately sell or close their practices, says Dorothy Steed, CCS, CDIP, revenue cycle consultant in Atlanta. Here are six tips to improve the denial rate at your practice.

G71.01 is, literally, the code for Duchenne muscular dystrophy.  Q93.51 stands for Angelman syndrome, and G40.419 covers generalized and treatment-resistant epilepsies, which groups like Orphanet and the American Epilepsy Society define as including Dravet syndrome. All three designations are among some 70,000 other diseases listed in the...

Say goodbye to RUG-IV, and hello to the Patient-Driven Payment Model (PDPM). This is a daunting task, not for the faint of heart. Under PDPM, reimbursement for Medicare Part A patients in SNFs will be driven by patient condition, rather than by therapy minutes provided. Documentation is crucial to a successful Recovery Audit Contractor (RAC) audit.

Billing is essential to any business, but few must contend with the challenges associated with medical billing. Healthcare organizations are required to navigate a labyrinth of insurance payers, patient copays and regulatory requirements, which often leads to lengthy periods between services...