All posts by Sarah Terry

RAC Appeals

Watch for New Issues in the RAC Appeals Process

Expect a mad dash to eliminate the backlog

For years, you’ve endured an agonizingly slow claims appeals process due to the enormous backlog of pending appeals. But now, the U.S. Department of Health and Human Services (HHS) Office of Medicare Hearings and Appeals (OMHA) is rapidly speeding things up. Find out what this More..


Get a Sneak Peek at New Diagnostic Radiology CPT® Codes for 2019

Start using 4 new breast MRI codes this January—and double-check medical necessity

You have a whole host of Current Procedural Terminology (CPT®) coding changes to deal with for 2019 – and you can’t afford to overlook a single new, revised, or deleted code. From significant revisions to coding fine needle aspiration (FNA), to new ultrasound elastography codes, More..


2019 Ob-Gyn CPT® Codes: Buckle Up for Dozens of Changes

Check out new E&M codes for technology advancements

On September 5, the American Medical Association (AMA) released the 2019 Current Procedural Terminology (CPT®) code set, containing more than 500 changed codes—that is, additions, revisions, and deletions. And coders for the ob-gyn specialty haven’t been spared from upheaval. Find out what to expect for More..

Shoulder Surgery

3 Expert Tips to Boost Your Shoulder Surgery Coding Skills

Important: Don’t let modifier 59 ruin your arthroscopy claims

Although orthopedic societies have pushed to make shoulder surgery coding more akin to coding for other joint procedures, many Medicare guidelines still consider the shoulder as a one-compartment joint. In other words, while there’s been some movement toward the two-compartment viewpoint, many coding guidelines for More..

Evaluation and Management

Prepare Now for an E&M Reimbursement Revolution

Your payment will be cut in half when you use modifier 25

Ground-breaking changes to Evaluation and Management (E&M) documentation and payment are on the horizon, and the impact will vary widely depending on your specialty. Can you look forward to a pay bump—or a reimbursement reduction? Read on to find out. The scoop: CMS recently released More..