Most providers, hospitals, systems, and physician practices have long implemented Electronic Health Records (EHRs). In conjunction with myriad clinical modules, revenue cycle modules have also been installed covering patient access, charging, coding, and [...]

JW Modifier: Drug Amount Discarded/Not Administered to any Patient

“Revenue Integrity” within a healthcare system means many different things depending on who you ask, the size of the institution, and if the OIG (Office of Inspector General) has paid a visit or not.

As of January 1, 2015, the AMA is overhauling a select group of presumptive testing laboratory CPT codes. This shift moves us from a structure based on an identifying code for type of test performed to one that groups like tests based on number performed [...]

As of January 1, 2015, CMS made changes to how the modifier -59 should be used. Current guidelines result in -59 being used incorrectly on a frequent basis and as a result of this misuse, there is a high risk of overpayment and audit from OIG, RAC, or [...]