Coding best practices are indispensable

To be financially successful, practices must find ways to lower costs and increase revenue. With rising business costs, it is imperative to capture every dollar by plugging all sources of revenue leakage. It is the diagnostic and procedural codes submitted with claims that mandate the quantum of reimbursement paid to physicians for services rendered. Here, some coding best practices are explored to maximize reimbursement.

One of the significant areas of concern for practices is incorrect medical coding and consequent rejection of claims. Further, lack of follow-up results in the ballooning of accounts receivable. Notably, a substantial amount of AR is never collected from payors. (more…)

The need for certified medical coders

Change is constant in medical coding due to medical and technological breakthroughs, evolving health insurance legislation and changes in codes on account of other factors. Hence a healthcare facility is always in need of experienced medical coders with the required certification. Thus, when an employer hires a coder with a professional certification, they can be confident the candidate has the required knowledge and skills proficiency.

Medical coding is not a straightforward process and nearly 8.5 percent of total claims in a multispecialty facility are denied the first time. Re-working claims are expensive. Hence coders are required to be knowledgeable in their specialties as well as keep up with the constant changes in the codes and payor guidelines. (more…)

Podiatry as a specialty is quite different and coding professionals need to be aware of the complexities in this specialty to reduce denial of claims. Medicare and commercial payors insist on medical necessity for foot care and thus, coding in podiatry specialty and revenue cycle management (RCM) is an area where confusion reigns. Most of the payors will reimburse if there is a foot condition but not for its preventive care. Hence podiatry coding procedures need to be dealt with carefully. (more…)

WHAT IS MEDICAL CODING?

The AAPC defines medical coding as “the transformation of healthcare diagnosis, procedures, medical services, and equipment into universal medical alphanumeric codes.” The codes for recording diagnoses and procedures are decided based on medical records, such as transcription of physician’s notes, laboratory and radiologic results, etc. Medical coding services are carried out by professional coders who are certified.

WHY IS CODING NEEDED? 

Even for a simple visit to the doctor, symptoms are recorded, procedures are performed and prescriptions for medicines are made out. And all of this information is coded by professional coders. As illnesses get more complicated, the amount of data to be conveyed to payors is much more. Thus, medical coding enables the efficient transmission of vast amounts of data. Moreover, it allows for uniform documentation of illnesses and treatments between medical facilities. At a national level, federal agencies use coding to track the prevalence of diseases. (more…)

Bristol Healthcare Services a leading company in revenue cycle management was a Bronze sponsor in 14th Healthpac Annual Users meeting conference at Savannah Desoto Hilton, Liberty St., Savannah, GA 31401 from 22 Feb to 24 Feb.

The conference witnessed the active participation of 130+ representatives of nation’s 30 major medical billing companies. Bristol being the Bronze sponsor for the event also shared its vision on implementing new software and upgrading existing technologies. (more…)

For 2017, the AMA revised the codes and coding rules for moderate (conscious) sedation. In prior years, moderate sedation was bundled to with nearly 450 CPT® codes. Now, moderate sedation is always reported and paid separately, when medically necessary and properly documented. (more…)