Medical Billers and Coders

For the last couple of years, cardiology practices have encountered increasing administrative and overhead costs which have prompted a substantial decrease in payment reimbursements for cardiologists. As of late, cardiology practices have increased in size because of the advancing nature of this stream and the emergence of various ailments and their remedies. This has caused apprehension amongst practicing physicians as to how to evaluate and address the changes that are taking place or are being proposed. Henceforth, they rather pay attention to cardiovascular medicine than administrative or structural aspects of their practice.  Industry Fact File  The essential nature of the Cardiology industry has maintained demand and supported the industry expansion in the last five years. The increasing overhead expenses and lack of interest in administrative activities have prompted decreasing profit margins. The industry is fixed at $34 billion and annually it is slated to develop at ...

Determining anatomical location and laterality needed by ICD-10 is simpler than you might suspect. This detail reflects how physicians and clinicians communicate and what they focus on – it involves guaranteeing the data is caught in your documentation. In ICD-10-CM, there are three fundamental classes of changes Definition Change; Terminology Differences; Increased Specificity. For cardiology, the center is increased specificity and documenting the downstream impacts of the patient's condition. Acute Myocardial Infarction (AMI) When documenting AMI, include the following: Timeframe An AMI is now considered “acute” for 4 weeks from the time of the incident, a revised timeframe from the current ICD-9 period of 8 weeks. Episode of care ICD-10 does not capture the episode of care (e.g. initial, subsequent, sequelae). Subsequent AMI ICD-10 allows coding of a new MI that occurs during the 4 weeks “acute period” of the original AMI. (ICD-10 Code Examples: I21.02; I21.4; I22.1) Hyper...

A few things in life are exceptionally easy and straightforward. Unfortunately, purchasing things such as splints, prosthetics, and durable medical equipment ( DME ) – and figuring out which orthotics are covered by insurance – isn't so cut and dried. In fact, a ton can turn out badly with regards to orthotics and prosthetics billing. Thus, to make sure your patients get with they need – and you get paid what you merit – stick to the accompanying rules.  The information beneath alludes to how Medicare reimburses for prosthetics and orthotics and doesn't necessarily reflect how commercial payers repay for these medications. At the same time, many commercial insurance payers align themselves with Medicare policies, so this should fill in as a decent general guide.  For prosthetics, Medicare reimbursement includes evaluation, fitting, parts and labor, repairs due to normal wear or tear within the initial 90 days of the delivery date, and adjustments made during the fitting and wi...

The Centers for Medicare and Medicaid Services (CMS) announced updated guidance regarding several emergency waivers identified with Medicare and Medicaid policies and regulatory updates during this pandemic for durable medical equipment suppliers. The CMS probably will continue to announce supplemental guidance on the sweeping waivers.  Here we have a definite summary of the significant waivers that will influence durable medical equipment suppliers, prosthetics, orthotics, and supplies (DME) and are projected to set up the American healthcare system with maximum adaptability to respond to the public health emergency. These brief changes will remain as a result across the U.S. healthcare system for the duration of the pandemic emergency declaration.  By enacting these waivers, CMS hopes to "put patients over paperwork" to give some relief from the vast documentation work, reporting, and audit requirements. Presently providers and regulators can focus on providing the required...