Here's The Latest in Health Care:
• Failing to support the acuity of the medical service rendered with coding and documentation is the number one reason payers deny a hospital claim over a coding issue, according to a new report. Other top causes for denials include if the procedure code is inconsistent with the modifier used or a required modifier is missing, the diagnosis is invalid for the date or dates of service documented, the diagnosis is inconsistent with the procedure, or the diagnosis was not covered at all. Read More
• Nearly one-third of older U.S. adults visit at least five different doctors each year, reflecting the growing role of specialists in Americans' health care according to a new study. On average, beneficiaries saw a 34% increase in the number of specialists they visited each year, while the proportion of patients seeing five or more doctors rose from about 18% in 2000 to 30% in 2019. Read More
• Providers are having a difficult time billing for services related to COVID-19, with 40 percent of charges for coronavirus-related care initially winding up as claim denials in the first 10 months of 2021, according to a recent analysis of more than $100 billion worth of denials and $2.5 billion in audited claims. Read More
• The Centers for Medicare & Medicaid Services has released the final physician fee schedule rule that sets out payment rates for 2022. In addition to including several provisions that aim to expand flexibility for telehealth reimbursement for mental health, including removing geographic restrictions, the rule will also let the 3.75% temporary pay bump given to physicians for 2021 expire. Read More
Each Friday, Signor Goat reports the latest from the week in health care. Check back next Friday for your dose of our little medical corner of health care news. Brought to you by pMD, innovators in charge capture, medical billing, revenue cycle management, telehealth, secure messaging, clinical communication, and care navigation software.