Tech Innovations for the Healthcare Sector: How to Bridge the Gap with Coding

tech innovations

In the year 2020, there are not many industries left that haven’t been modernized and streamlined by innovative technology. The healthcare sector itself has seen numerous improvements in recent years, including cutting-edge treatments, less invasive procedures, digital health records, mobile healthcare apps, and more (Medium/Healthcare in America, 2018). Most of these technologies alone have improved the level of care, efficiency, disease control, and access to better treatments (UIC, 2020). How medical coding adapts to new healthcare technology will have a great impact on preventive and corrective healthcare (Healthcare Business & Technology, 2020).

Read More

The Importance of Specificity in Documentation and Coding HCCs

HCC specificity

As a follow-up to our previous articles on the subject of Risk Adjustment and HCCs, we now review some scenarios of HCC chronic conditions and the importance of specificity in documentation and coding. Accurate and complete documentation of chronic condition diagnoses by clinicians is an essential component of the risk adjustment and the HCC process. It is also imperative that the documentation of a disease/condition be as specific as possible. Specificity can make a difference in the patient’s treatment plans, as well as accurate code assignments, which then leads to appropriate HCC assignment and payment.

Read More

Selecting the Right COVID-19 Code: Should You Use CPT or HCPCS?

COVID-19 Code

On March 11, the World Health Organization (WHO) issued a declaration of the COVID-19 as a global pandemic. Two days later, the AMA announced the development of a specific code for laboratory testing for the coronavirus, code 87635 (AMA, 2020). The Centers for Medicare and Medicaid Services (CMS) released two new HCPCS codes for coronavirus testing for Medicare claims. The reporting for COVID-19 testing is dependent on the payer, either an HCPCS or CPT code should be used; there should not be more than one COVID-19 testing code on a given claim.

Read More

Artificial Intelligence in Healthcare: How Natural Language Processing Can Benefit the Medical Field

Artificial Intelligence

Artificial intelligence (AI) can help transform patient data into value at an accelerated pace without incurring high costs or eating up limited time and resources (Wolters Kluwer, 2020). The AI algorithms produce insights into treatments, care processes, diagnostics, and patient outcomes (Health IT Analytics, 2018). Natural Language Processing (NLP) tools, one branch of AI, “include applications such as speech recognition, text analysis, translation, and other goals related to language,” according to Future Healthcare Journal (2019).

Read More

Weighing the Differences and Similarities of ProFee Coding and Facility Coding

ProFee Coding

Physician group acquisition by major health systems remains a common trend in the industry. One survey of over 8,700 physicians indicates that only 31% of physicians surveyed identify as an independent practice owner or partner as of 2018. This is down from 48.5% in 2012, a whopping 35% decrease in independently owned practices in only 6 years (Merritt Hawkins, 2018). In these acquisitions, the question remains: Who will manage the physician group?

Read More

Is the ICD-10 PCS Coding and Implementation System Worth the Trouble?

ICD-10 coding system

The 10th release of the International Classification of Diseases (ICD-10) is the most recent cutting-edge edition to the system of codes that categorizes every disease or health problem around the globe. The earlier edition was published about four decades ago, and henceforth the release of ICD-10 coding was predicted as a sweeping change in the world of medical coding.

Read More