The number of Medicare beneficiaries who were on cholesterol drugs went up in between 2014 to 2018 but total costs decreased, a study published in JAMA Cardiology found that switching patients to generic cholesterol drugs saved Medicare billions of dollars. In the study, researchers used the Medicare Part D Prescription Drug Event Database to collect […]
The American Medical Association (AMA) strongly disagreed, and the AMA’s CPT® panel got to work on revisions. It takes time to revise CPT® codes and definitions., but the CPT® editorial panel made changes in 2019 that will take effect in 2021. There wasn’t time to put these changes in the 2020 book, and the guidelines […]
(DSM-5) – The Diagnostic and Statistical Manual of Mental Disorders (DSM-5) is the official set of recognized mental health diagnoses for mental health providers in the United States. Developed and maintained by the American Psychiatric Association (APA). DSM-5 includes nearly all of the guidance a provider may need to diagnose any recognized mental disorder, which […]
ICD-11 presented at the World Health Assembly in May 2019 for adoption by Member States, and will come into effect on 1 January 2022. This release is an advance preview that will allow countries to plan how to use the new version, prepare translations, and train health professionals all over the country. The ICD-11 is […]
Oncology coding is the base of your oncology practice. If you code correctly then your practice is on the path of success. If there are any mistakes then your medical billing and coding in need of attention. In many cases, in house oncology biller is not possible, training and turnover are issues. Outsourcing your billing […]
Modifier 25 is a particularly meaningful coding tool for physicians who bill for evaluation and management (E/M) services. CPT guidelines define the 25 modifier as “Modifier 25 is defined as a significant, separately identifiable Evaluation and Management (E/M) service by the same physician or other qualified healthcare professional on the same day of the procedure […]
The emergence of coronavirus disease 2019 (COVID19) and the new treatments that have followed, to track the use of treatments is critical and their effectiveness is real time. The CMS responded this need, and in record time is implementing new procedure codes to allow Medicare and other insurers to identify the use of the therapeutics […]
The CPT Code 90791 is used for psychiatric diagnostic evaluations without medical services. It was created in 2013, along with 90792, to replace the former psychiatric diagnostic evaluation codes 90801 and 90802. This code is flexible in that it can be used by clinical psychologists, licensed professional counselors, licensed marriage and family therapists, and licensed […]
According to capitated contract payments agreed by a health insurance company and a medical provider is called Capitation payment in healthcare. This payment is fixed, pre-arranged monthly payments received by a physician, clinic or hospital per patient enrolled in a health plan, or per capita. The United States of America currently ranks highest among developed […]
The CMS is encouraging clinicians who are participating in the Quality Payment Program (QPP), such as Physicians, Assistants, Nurse Practitioners and others, to who are contributing to scientific research and evidence to fight the COVID-19 pandemic. CMS will reward with credit in the Merit-based Incentive Payment System (MIPS). A performance -based track of QPP that […]