CMS Releases First Payment Rules for FY 2022
Published: Tue, 04/13/21
CMS Releases First Payment Rules for FY 2022 The Centers for Medicare & Medicaid Services (CMS) has issued its first proposed payment rules under the…
Medical Coding Pro
Medical Coding practice exams and exam preparation tools and information
5 Use Cases for AI in Behavioral Health Practices
Published: Wed, 03/31/21
5 Use Cases for AI in Behavioral Health Practices With dwindling provider availability and a growing patient population, the healthcare industry is…
Top Challenges, Opportunities of Medical Coding and Billing
Published: Mon, 03/29/21
Top Challenges, Opportunities of Medical Coding and Billing By April of last year, seemingly every news station in American was featuring the heroic…
A Novel Approach to Defending Technical Denials
Published: Tue, 03/23/21
A Novel Approach to Defending Technical Denials For years, providers have been plagued with defending claims for medically necessary services that…
Integrating COVID-19 into Coding and Clinical Documentation Integrity
Published: Mon, 03/15/21
Integrating COVID-19 into Coding and Clinical Documentation Integrity Understanding how to clinically validate sepsis and differentiate between sepsis…
Skilled Nursing Facility Staffing Impacted by New Payment Rules
Published: Wed, 03/10/21
Skilled Nursing Facility Staffing Impacted by New Payment Rules Skilled nursing facility (SNF) staffing levels across several provider types have…
OIG: Hospitals are upcoding severity levels for Medicare patients
Published: Tue, 03/02/21
OIG: Hospitals are upcoding severity levels for Medicare patients A new report from the Department of Health and Human Services' Office of the…
Death of the Inpatient-Only List is NOT the Death of Medical Necessity
Published: Fri, 02/26/21
Death of the Inpatient-Only List is NOT the Death of Medical Necessity For readers of and listeners to RACmonitor and Monitor Mondays, overthinking…
Payer Split-Bill Requirement: Separate Claims to Avoid Edit
Published: Thu, 02/25/21
Payer Split-Bill Requirement: Separate Claims to Avoid Edit In December 2020, the Centers for Disease Control and Prevention (CDC) announced si new…
COVID-19 CPT coding and guidance
Published: Wed, 02/24/21
COVID-19 CPT coding and guidance New Current Procedural Terminology (CPT®) codes have been created that streamline the novel coronavirus testing…