Revenue Cycle Insider

Procedure Focus:
Get the Answers to Your Frequently Asked Anesthesia for GI Endoscopy Questions
Remember: the dx you report may not be related to the GI condition. While some physicians... Read more
Documentation:
Address These Key Fields, Complete ABNs With Ease
Don’t forget that every ABN form must be one single page. As every anesthesiology pract... Read more
Practice Management:
Try These Tips for Boosting Financial Literacy
Hint: Make sure you involve providers, so they understand the ripples of their work. Maki... Read more
CPT® 2025:
Adopt These E/M Changes Before January 1 Hits
Say goodbye to 99441 through 99443 next year. When CPT® 2025 becomes effective on Jan. 1... Read more
2025 Updates:
Get Ready For New 2025 Category III Codes
Remember: Category III codes have an expiration date. Although you won’t gain any new c... Read more
Education:
Conquer Coding Education Challenges With Expert Advice
Consider starting with E/M concepts first. In their 2024 HEALTHCON session titled “Tag... Read more
Reimbursement:
Join WCA In Their Fight Against Optum Per Diem Payment
Wisconsin OCI to scrutinize whether Optum limits access to quality chiropractic care. ... Read more
Coding:
Wield Your Imaging Edge With the New X-ray CPT® Codes for 2016
Enjoy wider range of Code choices for spinal X-rays. There’s a lot to learn from... Read more
Reimbursement:
Make the Most of 0.5 Percent Increase in Medicare Physician Fee Schedule
Noncompliance with EHR and PQRS to affect the non participating providers. Get ready f... Read more
Procedure Coding:
Answer These Questions to Code Lesion Removals Correctly
Always wait on pathology report before deciding on malignancy. Dermatology coders look... Read more
Case Study Corner:
Improve Lesion Removal Smarts with These Scenarios
You might be able to report a separate E/M in some instances. Check out these case stu... Read more
Compliance:
Make Medicare Status Change Before 2017
Remember: Participating providers receive five percent higher fees for services. As th... Read more
Coding:
Let These 3 Tips Lead You to New vs. Established Patient Clarity
You can collect more for new patients — but check these guidelines first. What’s the... Read more
Continuing Education:
Use This Guidance to Improve Your Coding Education Process
Check out these tips for more effective clinician communication. Coding education is an... Read more
Compliance:
Review This False Claims Act Case, Learn How to Avoid Big Fines
Strengthen your understanding of MDM guidelines. As you may know, the Department of Just... Read more
Inpatient Facility:
3 Ways to Make More Strategic Decisions For Your Rehab Facility
Making time for training pays off in unexpected ways. Growing up in Kentucky, Renee Ki... Read more
ABNs:
Prevent Lost Revenue for Uncovered Procedures
Meet with your patients to improve ABN success. Good news, rehab providers: A signed a... Read more
Regulations:
Final Rule Roundup
Get a breakdown of the key provisions in the final rules that will impact your practice ... Read more
Procedure or ED E/M?:
Use This Guidance for Treating Lacerations With Surgicel
Report with wound repair codes, include in E/M code … or something else? Laceration re... Read more
CPT® Basics:
Decipher the Symbols in Your CPT® Code Book for Easier Code Selection
These notations can help coders better master each code’s guidelines and descriptors. ... Read more
ICD-10 Coding:
Update Your Understanding of Asthma Coding
And don’t forget cause/effect sequencing. Earlier this year, the Centers for Disease C... Read more
FAQ:
Check Out the Answers to These Tummy Trouble Coding FAQs
See whether pediatric stomach pain is coded differently. When it comes to stomach issues... Read more
Practice Management:
Understand the 5 Challenges Remote Workers Face
Craft effective policies to maintain compliance. Remote workers face several challenges... Read more
CPT®:
Decipher the Symbols in Your CPT® Code Book for Easier Code Selection
These notations can help coders better master each code’s guidelines and descriptors. ... Read more
Procedure Coding:
Take These 5 Tips, Accurately Code Upper GI Scope Exams
Hint: Determine how far the scope went. According to one study, the average general surge... Read more
Coding Deep Dive:
Answer the How, What, When, and Why for Preoperative Evaluations
Don’t forget to check for comorbid conditions. Knowing how to navigate and select all ... Read more
Practice Management:
Improve Provider, Coder, Biller Relations, Improve Outcomes and Revenue
Three different roles, the same shared goals. In her presentation “Documenting and Codi... Read more
HIPAA:
Measure Your Disaster Smarts With 10 Tough Privacy Questions
Remember, HIPAA applies to volunteers, too. When a natural disaster strikes, the last thi... Read more
Artificial Intelligence:
Get Ready for These AI Updates in CPT® 2023
Hint: Analyzing data is just one piece of the AI puzzle. There’s no denying that artifi... Read more
Revenue Booster:
Bolster Your Email Security with 10 Top Tips
Hint: Quiz staff on phishing ploys. Even the most tech-savvy folks get duped by email phi... Read more
Diagnosis Coding:
Master 7th Character Selection Injuries and Complications
Don’t look to aftercare Z codes when caring for an injury. Knowing which seventh... Read more
Expect More 7th Character Options for Fractures
When it comes to fractures, your Chapter 19 seventh character options expand to allow yo... Read more
Coding Quiz:
Can You Assign the Correct 7th Character in These Scenarios?
Take note of expanded options for fractures. While “D” for subsequent enco... Read more
Patient-Driven Groupings Model:
Proposed 4% Budget Neutrality Adjustment Continues HHAs’ Death By A Thousand Cuts
CMS calls for an overall 1.7 percent payment reduction in 2025 proposed rule released June... Read more
Reimbursement:
Take A Closer Look At Your Proposed Rate Change
Don’t stop at base rate when gauging proposed cut’s effect on your pay. The base pa... Read more
Compliance:
Medicare Wants To Inspect Your Patient Acceptance Policies
New CoP would cost HHAs nearly $3.2 million in first year. Don’t be surprised if a newl... Read more
ICD-10:
Final Word on ICD-10 Yet to Come
Start learning your way around the ICD-10 manual. What’s next? Ever since the su... Read more
Hospice Coding:
Don't Delay: Prepare Hospice Coding Staff for Increased Focus on Diagnosis Coding
CMS asks for your input about terminal illness, related conditions definitions. Your h... Read more
Managed Care:
Counties Covered By MA Hospice Plans Will Nearly Double In 2022
Don’t make the mistake of thinking you won’t be affected if you don’t operate in one... Read more
VBID:
5 Medicare Advantage Plans To Offer Hospice Benefit
Tip: Remember you have to bill both the managed care plan and Medicare for VBID carve-in ... Read more
Regulations:
HOPE Tool Continues Path To Implementation
November Care Compare refresh, new HQRP resources also discussed in forum. Just because... Read more
Code Updates:
Prepare for Radiology Coding Changes With the 2025 ICD-10-CM Release
Specify unspecified tenosynovitis diagnoses. On Oct. 1, 2024, the Centers for Medicare &a... Read more
Code Updates:
ICD-10-CM Makes Eating Disorder Documentation More Specific
Also, synovitis/tenosynovitis combo code expands. ICD-10-CM has released its list of ne... Read more
Documentation:
Dive into Malnutrition Diagnosis Documentation
Use the GLIM criteria to help you recognize requirements. An unsupported malnutrition dia... Read more
Policy/Reimbursement:
Is the Current Pause of QIO Reviews a Lull Before the Storm?
Check with the QIOs for your denied claims status before you take to appeals. In a yet... Read more
Policy/ reimbursement:
Are You Ready for the MACRA Overhaul of the Existing Payment Systems?
AMA wants the implementation to be postponed to July 2017. Get ready for transition to... Read more
Procedure Coding:
Make These Codes Count for School, Sports, Work Physicals
Maintain your coding fitness with preventive E/M codes. If your practice is like most int... Read more
Billing:
Use These Reciprocity Rules When Your Physician Is Away
Know the dos and don'ts of reciprocal billing. Every practice has its procedures for prov... Read more
ICD-10 Coding:
Take These Steps, Get Relief from Pressure Ulcer Coding
Sequencing, site, laterality, severity key to L89 specificity. As a coder, you've probabl... Read more
Quality:
Brace Yourself for Focused Surveys And Compliance Probes
Scrutiny of quality of care likely to reach new highs in 2016. The Centers for Medicar... Read more
MDS 3.0:
Heed These Changes to CAT Specs
Revisions are effective Oct. 1, 2016. Delirium and cognition loss are among the Care A... Read more
ICD-10:
Nail Down Your Understanding of ‘With’ to Boost Coding Success
Hint: Don’t depend on the alphabetic index when searching for ‘with.’ The ICD-10-C... Read more
News You Can Use:
Should Your Facility Invest in Gaming?
Get a glimpse of a near future where resident activities turn virtual. People of all ages... Read more
Industry Updates:
CMS Announces Changes to SFF Program
Beware of more, expanded enforcement actions. The Centers for Medicare & Medicaid Ser... Read more
ICD-10-CM:
Identify Location, Site, Complications to Choose Correct Atherosclerosis Dx
Hint: You must know if the patient also has angina pectoris or not. Coding for atheroscl... Read more
Medicare Tips:
Sharpen Your Medicare Signature Knowledge
Resolving your questionable signatures prior to claim submission is key. In your medica... Read more
Surgery Spotlight:
Help the Slipper Fit by Coding Cinderella Surgeries Correctly
Whether for cosmetic or therapeutic purposes, these procedures can prove essential. Cin... Read more
Multiple Procedures:
Focus on Debridement Types Before Adding 59
Remember, anatomical area is not an issue for these services. When a physician perform... Read more
News You Can Use:
Note New POS to Nail 'Off-Campus' Coding
Anticipate imminent changes in payment for off-campus provider-based clinics. As of Ja... Read more
Catastrophe/Disasters:
Prepare for the Worst with Modifier CR Smarts
President must make declaration before you can use modifier. While no one wants to thi... Read more
Diagnosis Coding:
Get Documentation Details Right to Nail Dx Codes
Make sure laterality, anatomy are marked in codes if necessary. A big part of diagnosis c... Read more
Artificial Intelligence:
Ask These Questions When Searching for an AI Coding System — Part 2
Will the price point deter future adopters? Last month, we examined some key questions me... Read more
Modifier Madness:
Append Assistant at Surgery Modifiers Correctly
Hint: Do not report modifiers 80 and AS together. Modifiers are important to your medical... Read more
Surgery:
Know Area Before Coding Neurostimulator Arrays
A trio of code sets represents these surgeries. Patients requiring open neurostimulator e... Read more
Medicare Physician Fee Schedule:
Here’s the Big News in the 2025 Proposed Rule
Big surprise: Another rate cut is coming. The Centers for Medicare & Medicaid Servic... Read more
Modifier Madness:
Append Assistant at Surgery Modifiers Correctly
Hint: Do not report modifiers 80 and AS together. Modifiers are important to your medica... Read more
Item Focus:
M1340: Use 6 Pointers To Know which Wounds Make the Surgical Wounds Cut
Hint: Look to the OASIS Q&As when you’re stuck with this item. It’s no... Read more
Tool:
Answer Common M1340 Questions with this Chart
Stay up-to-date for greatest accuracy. OASIS item M1340 — Does this patient have... Read more
OASIS-C1:
Prepare to Move Forward with OASIS-C1
New assessment form will go into effect before ICD-10. If you’ve been looking fo... Read more
Obstetrics:
Tubal Ligation Claims: Here’s Why Some Payers May Still Balk at +58661
Is a tubal ligation bundled with a cesarean section? Find out. Have a tubal ligation clai... Read more
Gynecology:
Adhesiolysis Myths Debunked: You Can Sometimes Report it Separately
Here are the words your ob-gyn’s documentation needs to contain. Time and time again, ... Read more
News You Can Use:
Get Ready for Pertinent MPFS 2025 Updates
See how telehealth has evolved. The Centers for Medicare & Medicaid Services (CMS) ha... Read more
ICD-10-CM Coding:
Solve the Active vs. Personal History Dx Coding Conundrum
Hint: Treatment documentation is key. One of the most common areas of confusion when it c... Read more
Remote Physiological Monitoring:
Know the Dos and Don’ts of RPM Coding
Hint: Time is money. As healthcare technology advances, more digital medicine services â€... Read more
Practice Management:
Improve Provider, Coder, Biller Relations, Improve Outcomes and Revenue
Three different roles, the same shared goals. In her 2024 Regional HEALTHCON presentatio... Read more
CPT® 2025:
Get to Know the 2025 CPT® Revisions
Be prepared for a host of new telemedicine codes. It won’t take a lot for you to stay a... Read more
E/M Coding:
Let These 3 Tips Lead You to New vs. Established Patient Clarity
You can collect more for new patients — but check these guidelines first. What’s the ... Read more
Practice Management:
Improve Provider, Coder, Biller Relations, Improve Outcomes and Revenue
Three different roles, the same shared goals. In her presentation “Documenting and Codi... Read more
Reimbursement:
8 Things Your Optometry Practice Must Know About MACRA & MIPS in 2017
Good news: 2017 is a ‘Get Out of Jail Free’ card. Confused about what the ... Read more
Revenue Boost:
Is Your Practice's Optical Shop As Profitable As It Can Be?
This 6-question test says for sure. If you’re like most optometry practices, you... Read more
Revenue Boost:
Are Remakes Eating Away at Your Optical's Profits?
You don’t shell out for the cost of remakes immediately, but if you have a high re... Read more
CPT® Coding Strategies:
Perfect Your Dentoalveolar Excision Coding With These 3 Useful Tips
Hint: Don’t leave $240 on the table by failure to identify right type of repair. ... Read more
ICD-10 Coding:
Decide From Two Options When Reporting Diagnosis of Xerostomia
Hint: Don’t forget to report additional codes to identify alcohol or tobacco use. ... Read more
Medicare News:
Be Informed About OIG's Takedown of Those Receiving Kickbacks
Latest technology and data analysis helps capture more than 300 offenders. If you are ... Read more
Surgery Spotlight:
Understand the Ins and Outs of UCL Repair
How well do you know the elbow anatomy? When the surgeon performs work on an ulnar collat... Read more
Surgery Spotlight:
Help the Slipper Fit by Coding Cinderella Surgeries Correctly
Whether for cosmetic or therapeutic purposes, these procedures can prove essential. Cind... Read more
Modifier Madness:
Append Assistant at Surgery Modifiers Correctly
Hint: Do not report modifiers 80 and AS together. Modifiers are important to your medical... Read more
ICD-10 Coding:
Take These 4 Tips, Go to the Head of the Neoplasm Table
Learn the right way to code metastatic cancers. If you’re new to coding cancers of the ... Read more
E/M Coding:
Let These 3 Tips Lead You to New vs. Established Patient Clarity
You can collect more for new patients — but check these guidelines first. What’s the ... Read more
Documentation:
Address These Key Fields, Complete ABNs With Ease
Don’t forget that every ABN form must be one single page. As every otolaryngology prac... Read more
ICD-10-CM Coding:
Try Out These 2 Demanding ICD-10-CM Surgical Setting Scenarios
Use all guidelines at your disposal for post-surgical complications Getting to the bottom... Read more
Modifiers:
Learn The Ropes of Modifier 53 Coding for Terminated Biopsies
Consider a number of variables, including use of CT guidance. Biopsy coding can become a ... Read more
CPT® Coding:
Get Answers to 4 Pertinent Skin Biopsy Questions
Use these FAQs as a reference for your future skin biopsy claims. Any general surgery cod... Read more
Interventional PM:
Put Nerve Blocks, Pain Pumps on PM List
There are several types of nerve blocks for interventional PM. Patients reporting to the ... Read more
Q&A:
Get Your Incident-to Pay While You Still Can
When 2020 ends, so might incident-to. While incident-to might be on its way out, the bill... Read more
Compliance:
Feds Primed to Find Fraud in Opioid Prescribing
Get all your procedures in place to prevent trouble. As 2020 kicks off, PM practices find... Read more
E/M Coding:
Heed This Expert Insight to Correctly Code for Time
Compare these auditor red flags with your practice’s processes. Even for the most seaso... Read more
Revenue Booster:
Boost Your Health IT Checklist With These 10 Resources
See how each agency factors into the HIT equation. Navigating the regulatory waters of h... Read more
Part B Coding Coach:
Ease the Suffering With This Low Back Pain Coding Primer
Hint: Review ICD-10 guidance on coding back injuries. If you find coding low back pain ch... Read more
CPT® 2025:
Be Ready for Revised Genomic Sequence Codes, Updated HPV Options, and More
Know where to find resequenced codes in CPT® 2025. The official 2025 CPT® code set is o... Read more
ICD-10-CM Coding:
4 Tips Will Put You at the Head of the Neoplasm Table
Learn the right way to code metastatic cancers. If you’re new to coding neoplasms, the ... Read more
HIPAA:
Examine These 3 Cases, Stay Safe from HIPAA Violations
Avoid the fate of these healthcare entities with solid training and compliance strategies... Read more
News You Can Use:
Get to Know the 2025 ICD-10-CM Code Set
See how obesity coding is getting more precise. With more than 250 new diagnosis codes, t... Read more
Telehealth:
Keep Up With These Changes to Post PHE Telehealth
And get ready for telehealth codes to change again in 2025. During her HEALTHCON 2024 pr... Read more
Practice Management:
Boost Financial Literacy with This Expert Advice
Hint: Make sure you involve physicians, so they understand the ripples of their work. Ma... Read more
Fracture Coding and Casts:
Facilitate These Coding and Casting Tips for Fractures
Beware: E/M codes are not always billable. When a patient comes in with a broken ankle, y... Read more
Compliance:
Understand the 5 Challenges Remote Workers Face
Craft effective policies to maintain compliance. Remote workers face several challenges... Read more
Practice Management:
Improve Provider, Coder, Biller Relations, Improve Outcomes and Revenue
Three different roles, the same shared goals. In her presentation “Documenting and Co... Read more
Revenue:
Improve Provider, Coder, Biller Relations, Improve Outcomes and Revenue
Three different roles, the same shared goals. In her HEALTHCON Regional presentation “D... Read more
Coding:
Let These 3 Tips Lead You to New vs. Established Patient Clarity
You can collect more for new patients — but check these guidelines first. What’s the ... Read more
Staffing:
Understand the 5 Challenges Remote Workers Face
Craft effective policies to maintain compliance. Remote workers face several challenges ... Read more
Case Study Corner:
Correctly Code These RSV Bronchiolitis Cases
Also: review the RSV testing codes. One of the most common diagnoses that primary care pr... Read more
News You Can Use:
Get to Know the 2025 ICD-10 Code Set
Specify obesity classes with new codes. With more than 250 new diagnosis codes, the 2025 ... Read more
Practice Management:
Find 7 Myths and 1 Truth About Fee-for-Time Billing
Prep now for holiday fee-for-time fill-ins. Everyone needs a vacation, and primary care ... Read more
CPT® 2017:
Alter Your Psychotherapy Reporting Skills in 2017 Using These 3 Scenarios
Hint: Check CCI when reporting family therapy with individual therapy. As you get read... Read more
CPT® Coding:
Get Set to Refresh Family Therapy Reporting Beginning New Year
Hint: Report family codes only if time component is satisfied. As you make way for CPT... Read more
Collections:
Understand the Do's and Don'ts for Handling Nonpaying Patients
Try ‘hard’ collection as your last option. You might be familiar with situ... Read more
ICD-10-CM:
Learn 5 Tips to Elevate Your COPD Coding
Hint: pay attention to the ICD-10-CM code notes. Chronic obstructive pulmonary disease (C... Read more
Case Study:
Correctly Code These RSV Bronchiolitis Cases
Also: review the RSV testing codes. One of the most common diagnoses pulmonologists see d... Read more
Artificial Intelligence:
Ask These Questions When Searching for an AI Coding System – Part 1
Can NLP decipher language differences between doctors? Choosing the right artificial int... Read more
CPT® 2025:
Report MR Exam Implant Prep With 2025 CPT® Codes
Pay careful attention to the new guidelines. On Sept. 10, 2024, the AMA released the 2025... Read more
Practice Management:
Use This Guidance to Improve Your Coding Education Process
Check out these tips for more effective clinician communication. Coding education is an o... Read more
Artificial Intelligence:
Ask These Questions When Searching for an AI Coding System – Part 2
Will the price point deter future adopters? Last month, Radiology Coding Alert examined s... Read more
Cybersecurity:
Discover 3 Passwordless Authentication Methods for Your Practice
Find out if biometrics and separate keys are the wave of the future. Clinicians have full... Read more
Telehealth:
Keep Up With These Changes to Post PHE Telehealth
And get ready for telehealth codes to change again in 2025. During her HEALTHCON 2024 pr... Read more
Best Practices:
Dissect Your Workflow to Streamline Operations
Hint: Patient satisfaction is all about setting expectations. In a medical practice, ord... Read more
Frequently Asked Questions:
Check Your Urinary Diversion Knowledge With These FAQs
Remember to append modifier 50 where necessary to avoid a denial. There are instances wh... Read more
CPT®:
Decipher the Symbols in Your CPT® Code Book for Easier Code Selection
These notations can help coders better master each code’s guidelines and descriptors. ... Read more
Practice Management:
Study These Strategies for Setting Up a Solid CDI Process
Understand the benefits of regular self-audits. Comprehensive clinical documentation is... Read more

Nov 18, 2024
Orthopedic Coding:
Make Sense of Arthroscopic Hip Labrum Surgery Coding
Note conservative Tx attempts before surgery option. The hip joint is a ball-and-socket j... Read more
Nov 18, 2024
Orthopedic Coding:
Get Dx to the Proper Character for Reiter’s Block
Question: What is Reiter’s disease, and how do I choose an ICD-10 code for the condition... Read more
Nov 18, 2024
Compliance:
Incorporate These 7 Elements Into Your Compliance Program, Part 1
Find out which innovative approaches can boost compliance across your organization. CJ Wo... Read more
Oct 30, 2024
Oncology Coding:
See How These 2025 CPT® Code Changes Will Impact Your Oncology Practice
Get a handle on these sweeping changes before the New Year arrives. Oncology practices ac... Read more
Oct 30, 2024
Gastroenterology Coding:
Correctly Code Blood Clot Removal During an EGD
Question: I have a report that states the gastroenterologist performed an upper gastrointe... Read more
Oct 30, 2024
Gastroenterology Coding:
Check New Colonoscopy Category III Codes, Updated Telemedicine Options
Plus: CPT® 2025 will roll out a new virtual check-in code. New gastroenterology-rel... Read more