Medical Billing Blog with Medical Billing & Coding Info & Articles
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Welcome to the medical billing blog containing news and articles relating to medical billing, medical coding, ICD, HIPAA and practice management functions.
2004-2024 Celebrating 20 Years of Healthcare RCM Articles
The Blog Currently Contains 1,265+ Healthcare Articles
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 …
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, …
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 …
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 …
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 …
