CDI and Medical Necessity: Closing the Gap Could Prevent Denials

Published: Thu, 01/18/18

CDI and Medical Necessity: Closing the Gap Could Prevent Denials

Medical policies are based off of evidence-based medicine. Without proper documentation, however, most providers struggle to get services or procedures covered for patients.

Medical Billing Codes Do Not Address Full Scope of Primary Care

Family physicians could not bill for all the services provided in the majority of their visits because CPT codes for medical billing did not cover the services, a study found.
ICD-10 Coding: Three Ways to Improve Quality: Consistency, Collaboration, and Education

Results of the 2nd Annual National Coding Productivity and Accuracy Contest were released in September 2017. Although accuracy rates were higher than reported following the same contest in 2016, quality remains significantly low compared to the 95 percent benchmark established in ICD-9.
How to Code for ‘Problem’ Discovered During Preventive Medicine Visit

The Current Procedural Terminology (CPT) manual offers guidelines on how to code for a “problem” that is addressed during a preventive medicine service. The guidelines cover “insignificant or trivial” problems as well as those that are “significant.”
MACRA: A Quick Study Guideline

The importance of learning and researching the details of MACRA cannot be overstated, especially since the topic is unknown to many healthcare entities.
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