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Surprise Billing Negotiations Continue in Congress

Posted Apr 22, 2020


For those who work in the healthcare industry, surprise billing is not a new concept. This practice impacts patients seeking all types of medical attention, and has been a topic of discussion among lawmakers in recent months. Attention from both the federal government and healthcare stakeholders has propelled this issue into one that might soon have a resolution, because both the House Ways & Means Committee and other significant groups in Congress have been working to find a solution. Congress has been at a stalemate for months regarding this issue, but recent proposals have sparked a new wave of negotiations and conversations by lawmakers to come to a resolution before the December 20th deadline. Keep reading to learn more about this issue and where it currently stands in Congress.

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Expanded coverage for Telehealth Services (COVID-19)

Posted Mar 17, 2020

We have received many inquiries on the reporting of telehealth codes due to CMS reducing the restrictions on telehealth services. As of today, these reductions are available for the diagnosis and treatment of any conditions and/or diseases retroactive to March 6, 2020. While there has been communication from some commercial insurance carriers as to their reduction in restrictions also, as of this notification, it is unknown if they will follow CMS. HIS will keep you updated if new developments change the restrictions.

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HIS Coding Updates

Posted Mar 12, 2020

HIS Coding Updates

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Medical Coding

How to Effectively Review Your Revenue Cycle Process | HIS

Posted Mar 3, 2020

Those in the healthcare industry are certainly no strangers to insurance claim payments being delayed or denied. Practices facing this issue are at a great risk for losing out on revenue throughout each year, because it is estimated that around 25% of denied claims are never paid at all. If your organization’s denial rates are particularly high, this issue is one that will need to be addressed and resolved so your practice can continue to serve patients and bring in revenue. One of the most effective ways to determine how to prevent such denials is to evaluate and assess your practice’s revenue cycle. Keep reading to learn more about how to conduct this type of assessment and how Healthcare Information Services can help optimize your revenue cycle for practice success.

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Revenue Cycle Management

September 2019 Coding Updates

Posted Dec 12, 2019

Intermediate and Complex Repairs

The descriptions for intermediate and complex repairs have been clarified
including adding the description for limited and extensive undermining.

Intermediate Repair- Intermediate repair includes the repair of wounds that,
in addition to the above, require layered closure of one or more of the deeper
layers of subcutaneous tissue and superficial (non-muscle) fascia, in addition
to the skin (epidermal and dermal) closure. It includes limited undermining
(defined as a distance less than the maximum width of the defect, measured
perpendicular to the closure line, along at least one entire edge of the defect)
Single-layer closure of heavily contaminated wounds that have required
extensive cleaning or removal of particulate matter also constitutes
intermediate repair.

Complex repair- Complex repair includes the repair of wounds that in
addition to the requirements for intermediate repair, require at least one of the
following; exposure of bone, cartilage, tendon, or named neurovascular
structure; debridement of wound edges (e.g. traumatic lacerations or
avulsions); extensive undermining (defined as the distance greater than or
equal to the maximum width of the defect, measured perpendicular to the
closure line along at least one entire edge of the defect); involvement of free
margins of helical rim, vermillion border, or nostril rim; placement of
retention sutures. Necessary preparation includes creation of a limited
defect for repairs or the debridement of complicated lacerations or avulsions

Scar revision has been removed from the description of complex repair.
Per the AMA, Scar revision in which skin is excised and closure is
performed should be coded as excision of benign lesion. This code will be
considered included in most other surgical procedures.

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