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Some providers are experiencing high-volume denials based on idiosyncratic edits, made-up rules, and black-box edits. I have lost count of the number of publications released this year addressing surprise billing, incorrect use of Modifier 59, over-documentation, note bloat, billing for unnecessary services, over-prescribing of opioids, and myriad other topics targeting…
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EDITOR’S NOTE: The following article was originally published on the American College of Physician Advisors (ACPA) blog by the author. I never really understood how my “square peg” of work as a geriatrician was supposed to fit into the “round hole” of evaluation and management (E&M) CPT® coding with its…
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When hospital executives are asked about their specialty programs, both in terms of reputation and profitability, orthopedics and cardiology are often on the top of the list. But that may soon be changing. A great deal of attention has been paid to the proposal by the Centers for Medicare &…
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How many of us remember the 90010? That was an evaluation and management (E&M) code in 1991, prior to the revision that still haunts us today. Back then, in the good old days, E&M codes were qualitative in nature, meaning that their use was based on physicians’ interpretation of the…