Tip of the Day: Review your top five denials every month to spot recurring coding issues. CodeMD proactively analyzes denial patterns to prevent the same errors from happening again. This approach significantly improves reimbursement rates. Call (713) 552-1410 or visit www.codemdbilling.com to boost your practice’s financial health! #DenialTrends #ProactiveSolutions #BillingEfficiency #FinancialHealth #CodeMDBilling

Confused by value-based care reimbursement models? CodeMD handles the intricacies of alternative payment structures, ensuring accurate coding and maximized returns. We manage these complex models so you don’t have to. Call (713) 552-1410 or visit www.codemdbilling.com for hassle-free value-based billing! #ValueBasedCare #AlternativePayments #AccurateReimbursement #BillingComplexities #CodeMDBilling

Medical coding is a fast-moving field, and each new year brings updates that providers must incorporate into their workflows. Whether you're managing a hospital, private practice, or outpatient clinic, staying on top of these changes is crucial to avoiding claim denials and maximizing reimbursement.

Notable CPT and ICD-10 Updates

This year, the CPT manual saw several revisions related to Evaluation and Management (E/M) services, telehealth, and chronic care management. Meanwhile, ICD-10 introduced new diagnosis codes for emerging diseases, mental health conditions, and complications related to long-term treatments.

Telehealth Coding Continues to Evolve

Telehealth gained tremendous momentum in re...

In today’s healthcare landscape, every detail matters—especially when it comes to medical coding. Accurate coding is more than just inputting numbers into a system. It’s the foundation that ensures healthcare providers are reimbursed correctly, patients are billed accurately, and organizations remain compliant with complex regulations.

The Financial Impact of Errors

Even minor coding mistakes can result in claim denials, delayed payments, and audits. Repeated errors may raise red flags with insurance payers or regulatory bodies, leading to costly investigations or penalties. That’s why having certified, detail-oriented coders is critical to protecting revenue streams.

St...

By Renee Dustman

By Bruce Pegg

Certain telemedicine services are already covered under the Physician Fee Schedule (PFS) when provided to Medicare patients in accordance with regulations. In response to the public health emergency (PHE) for the COVID-19 pandemic, the Centers for Medicare & Medicaid Services (CMS) has temporarily expanded telehealth coverage.
Effective March 6, CMS expanded the telehealth benefit under the Section 1135 waiver authority and Coronavirus Preparedness and Response Supplemental Appropriations Act. Under the wavier, Medicare can pay for office, hospital, and other visits furnished via telehealth across the country, including in patients’ homes. Since issuing the Section 1135 ...

Guest Contributor

Know when to use the co-surgeon, assistant-at-surgery, and surgical team modifiers.

Over the last few years, there have been line items on the Office of Inspector General’s (OIG’s) Work Plan related to co-surgeon and assistant surgeon procedures.

In a report from November 2022, the OIG performed a review of 100 sample services and found a 69 percent error rate:

• 49 percent were billed without the correct co-surgery modifier,


• 14 percent without the assistant-at-surgery modifier, and


• 6 percent were identified as duplicate services.

Extrapolated out to the universe of services, the OIG estimates that Medicare improperly paid healthcare providers $4.9 million during cale...

By Michael Shaughnessy

Tip of the Day: Regularly update fee schedules to align with payer contract changes. CodeMD handles these adjustments automatically, making sure you receive the full amount you deserve. It’s one more way we keep your finances healthy. Call (713) 552-1410 or visit www.codemdbilling.com to maximize reimbursements! #FeeSchedules #PayerContracts #FullReimbursement #FinancialHealth #CodeMDBilling