Posts Tagged ‘coding’
You should be billing G2211 in heavy volume, per CMS
Who remembers G2211? Starting in 2024 this CPT code took the mid-revenue cycle by storm. Despite paying very little ($16.04) it was intended to be used in quantity. It has been. A new study by the Journal of the AMA found that its first year of full use, calendar year 2024, G2211 was billed 26…
Read MoreNew 2027 ICD-10 codes are out (effective Oct. 1)—what you need to know
By Brian Murphy The 2027 ICD-10-CM (diagnosis) and ICD-10-PCS (procedure) codes are out. You can view them on the CMS website at the link below. They take effect Oct. 1, 2026. So what do we have? At a high level: ICD-10-CM: 190 new codes, 30 deletions, 4 code revisions ICD-10-PCS: 101 new codes, 38 deletions,…
Read MoreCoding in the Gray: Why Human Judgment Still Matters (part 1 of a 2-part series)
Download the report here. There is a LOT of talk these days about automation. Autonomous coding solutions that can code with near-perfect accuracy—and no human intervention. Providers picking a code from a drop-down menu, enabled by a computer-generated prompt, and voila: Maximized billing and denial-proof revenue. We’re not buying it. We’ve been hearing talk of autonomous coding since at least 2007-08, and it never seems to happen the way the predictions say. Denials persist. Errors continue. And more myths are perpetuated. What makes full…
Read MoreIf a GLP-1 drops your BMI under 35, is morbid obesity off the table?
By Brian Murphy At the ACDIS conference last week, an interesting obesity coding question posed during a Q&A session at the Outpatient Symposium: Should we continue to code morbid obesity for patients who were previously morbidly obese (BMI greater than 35 with obesity-related comorbidities), but because they are on an active GLP-1 their BMI is…
Read MoreFive things to know about Present on Admission (POA) for hospital payment, quality
By Brian Murphy Present on admission (herein POA) for coding purposes is defined as conditions that are present at the time the order for the inpatient admission occurs. It’s important to get POA status right, as it impacts payment and quality metrics. POA conditions (as reported with a Y) count as CCs or MCCs, whereas…
Read MoreAuto-Assisted Coding without Human Oversight a Massive Compliance Risk, Legal Liability
By Brian Murphy There’s been increasing discussion about the safe and ethical use of AI in healthcare. This week the House Energy and Commerce Subcommittee on Health held a session to explore how hospitals are using the technology. See link below (AHA). You won’t find regulations outlining the safe use of AI in healthcare, though…
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