Why Do Precise Lesion Measurements Directly Impact Dermatology Revenue?

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Precise lesion measurements directly impact dermatology revenue because coding, reimbursement levels, and medical necessity depend on accurate documentation of lesion size and complexity. In dermatology, even small  measurement differences can change procedure codes, alter reimbursement amounts, and trigger  claim denials  if the  documentation does not support the billed service. Accurate measurement is not just a clinical detail—it is a financial safeguard. Why Are Lesion Measurements Critical in Dermatology Billing? In dermatology billing , many procedure codes are selected based on lesion size. Excision, destruction, and biopsy codes often depend on the lesion's diameter, including its margins. Incorrect or incomplete measurements can result in: Downcoding Underpayment Overbilling risks Increased audit exposure Precise measurement ensures proper revenue capture . How Do Coding Guidelines Depend on Lesion Size? CPT coding for lesion removal...
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Skilled Nursing Facility 3- Day Rule Waiver

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CMS is waiving the requirement at Section 1812(f) of the Social Security Act for a 3-day prior hospitalization for coverage of a skilled nursing facility (SNF 3- Day Rule Waiver) stay provides temporary emergency coverage of SNF services without a qualifying hospital stay, for those people who need to be transferred as a result of the effect of a disaster or emergency. In addition, for certain beneficiaries who recently exhausted their SNF benefits, it authorizes renewed SNF coverage without first having to start a new benefit period. Second, CMS is waiving 42 CFR 483.20 to provide relief to SNFs on the timeframe requirements for Minimum Data Set assessments and transmission.

Background

Under the Shared Savings Program, the Centers for Medicare & Medicaid Services (CMS) enters into a participation agreement with each participating Accountable Care Organization (ACO). CMS will reward eligible ACOs when they lower growth in Medicare Parts A and B fee-for-service (FFS) costs (relative to their ACO-specific benchmark) if, at the same time, they meet performance standards on quality of care.

The SNF 3-Day Rule Waiver waives the requirement for a 3-day inpatient hospital stay prior to a Medicare-covered, post-hospital, extended-care service for eligible beneficiaries. Only Shared Savings Program ACOs that are currently participating in, or applying to, certain Shared Savings Program performance-based risk tracks have the opportunity to apply for a waiver of the SNF 3-Day Rule, and they must apply separately for the waiver during the annual application process.

Read more regarding Skilled Nursing Facility 3- Day Rule Waiver: https://bit.ly/3e5qNev. also you can get in touch with us at info@medicalbillersandcoders.com or call us at 888-357-3226.

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