Shoulder Surgical

Master CCI Edits For Shoulder Surgical Procedures

Use modifier 59 inappropriately, and it can cause you a “bundle” of problems

To get paid for all you do, you must correctly code each and every procedure performed—which sometimes means unbundling codes using modifier 59 (Distinct procedural service). However, to decide if and when modifier 59 is appropriate, you must do some heavy lifting. Appending modifier 59 More..


How (and Why) to Build a Telemedicine Practice

Smart: Account for costs as well as potential savings—and prep for compliance challenges

Twenty years ago, telehealth was more concept than reality, popular among visionaries but absent from most doctors’ offices. Today, telehealth is a rapidly growing industry changing the way practitioners and patients interact. The technology and the capabilities change almost daily. And then there are the More..

CMS Relaxes Inpatient Admission

Good News: CMS Relaxes Inpatient Admission Order Requirements

Here’s why you still should keep physicians providing this type of documentation

The Centers for Medicare & Medicaid Services’ (CMS) hospital compliance requirements are ever-changing and evolving. But sometimes, the CMS Hospital Conditions of Participation (CoP) requirements and Hospital Inpatient Prospective Payment System (IPPS) rule revisions change for the better. Case in point: You can expect changes More..

Price Transparency

5 Ways To Practice Patient-Centered Price Transparency

To stay competitive amid healthcare “consumerization,” hospitals must do more than the minimum

If you think your hospital’s work is done when it comes to price transparency, think again. Posting your chargemaster online is enough to comply with the CMS mandate, but you’re not doing your patients any favors. Reminder: According to the 2019 IPPS Final Rule, hospitals More..


Align Your Hospital Policies With Federal EMTALA Rules

When it comes to key terms, clarity is the key to EMTALA compliance

Emergency Medical Treatment and Labor Act (EMTALA) violations are expensive—and they’re not all that hard to come by. Unfortunately, the myriad regulations around the law’s components can trip up even the most compliance-minded hospital staff. EMTALA requires that you maintain a central log, proper EMTALA More..

Acromioplasty Coding

Don’t Let Acromioplasty Coding Rest Heavy on Your Shoulders

Make sure the documentation supports coding 29826

If you’re running into problems when reporting CPT code 29826 for acromioplasty, you’re not alone. Follow these expert tips to ensure that you’re coding properly and avoid unnecessary claim denials. Crucial: The most important thing to remember when reporting code 29826 is that it’s not More..