Medical Billing Blog with Medical Billing & Coding Info & Articles

Welcome to the Medical Billing and Coding Blog

Welcome to the medical billing blog containing news and articles relating to medical billing, medical coding ICD-10, HIPAA and all practice management functions.

Click any of the article links below or browse by section to the right to read articles on a specific subject.

Currently contains over 1,165 healthcare and medical related entries.

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Is Your EMR User Friendly?

A common complaint about EMRs is that while they might have technical capability, they might not have real world usability, or be “user friendly”. Thus, you might be able to enter A, B and C; but finding the previous values of A, B and C might be challenging, and seeing the history of A, B and C might not be possible. As I sat in front of one of my medical providers recently, who is a late and reluctant convert to EMRs, he created an on paper list of my previous values as he inefficiently hunted through my now online history. And unless he types them back in in a

By: Melissa Clark, CCS-P, RT - CEO
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EHR companies refuted claims of violating HIPAA

The EHR Association (EHRA) Executive Committee has fired back at accusations that EHR companies are partially to blame for interoperability problems, claiming health data exchange is progressing quickly. The association published a response to an earlier post on Health Affairs Blog that accused EHR and health IT companies of monetizing the custody of patient protected health information (PHI). Former ONC Chief Privacy Officer Lucia Savage urged the Office of Inspector General (OIG) to enforce provisions of HIPAA prohibiting business associates such as EHR developers from using PHI for business operations. She stated some EHR companies may be leveraging ownership of patient PHI for profit. “Building a revenue stream out of

By: Melissa Clark, CCS-P, RT - CEO
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How to Choose Between Modifiers 25 and 57

When reporting an evaluation and management (E&M) service on the same claim with another service or procedure, you must append either modifier 25 “Significant, separately identifiable evaluation and management service by the same physician or other qualified healthcare professional on the same day of the procedure or other service,” or modifier 57, “Decision for surgery” to the E&M service code. Modifier Identifies Separate Nature of E&M Service A minimal patient evaluation is necessary to determine that a prescribed treatment is appropriate to manage the patient’s condition. For example, if a patient presents for a previously scheduled injection, the provider will briefly evaluate the patient to confirm that the injection remains

By: Melissa Clark, CCS-P, RT - CEO
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Your Medical Billing Team is The Center of Your Business

Over the past three years, I’ve really managed to shift who makes policies, enforces policies, and understand why policies are made. Often times, leaders and managers who lack either training or experience create more and more policies rather than approaching a specific person about their behavior. Typing up a policy seems the least resistant way to handle a problem. But I warn you this is the worst approach to take. When you create policies for this reason, you are stifling and handcuffing your remaining staff, who will most likely end up leaving the company due to so many rules and policies. Let’s be clear here, I love structure and process,

By: Kathryn Etienne, CCS-P, RT - DOO
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Improving Patient Experience and Your Bottom Line

No matter how big or small your medical practice is, most administrative leaders and physicians are stressed about outcomes, paying bills, compliance, and — most importantly — keeping patients happy. Unfortunately, while realizing your practice has the same issues as any other brings a feeling of camaraderie, it doesn’t solve any problems. Many practices still carry the mindset that, “if you build it, they will come.” However, the day-to-day challenges of staying profitable in a challenging patient environment dominated by Google reviews and a major push for value-based care are becoming harder to bear. As patients are behaving more like consumers, practices need to embrace a patient-centered mindset in order

By: Kathryn Etienne, CCS-P, RT - DOO
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You Should Worry about Medical Coding Guidelines Changing

Changes are coming with Evaluation and Management (E&M) coding guidelines. I will use this space to explain why these changes will be both a good thing and a challenge to physicians, particularly those who derive much of their income from office visits. CHANGE IS OVERDUE It has been 20 years since the 1997 E&M guidelines were promulgated. They were confusing to most physicians then and remain confusing today. One study from the Journal of Family Practice showed that physicians are accurate in their E&M coding only 55 percent of the time, yet Mitchell King, MD provided a fascinating follow-up investigation in the Archives of Internal Medicine that showed certified coding

By: Melissa Clark, CCS-P, RT - CEO
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A New Platform for Educating New Doctors on EHR Use

Over the past few years, the Regenstrief Institute and the Indiana University (IU) School of Medicine began to notice a problem. While EHR technology had become ubiquitous in the healthcare industry, medical school curricula had not evolved to reflect this reality. This realization became the impetus for the Regenstrief Institute’s EHR Clinical Learning Platform. “It didn’t start out as this,” Regenstrief research scientist and Assistant Professor of Clinical Medicine at IU School of Medicine Blaine Takesue told EHRIntelligence.com. “It started from a different project here at IU,” he continued. “We’ve had proprietary EHR for decades and we noticed we didn’t do much in the way of direct instruction through the

By: Melissa Clark, CCS-P, RT - CEO
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Inventing New Medical Billing Codes

Are there still medical conditions that have no codes for billing in ICD-10?   Here is a graphic from Physician’s Practice on the subject…     Credit and See the original article at Physician’s Practice

By: Melissa Clark, CCS-P, RT - CEO
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