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4 / 23 / 2024

2023 Evaluation and Management Guideline Changes

By
Angela Wood
In January of 2021, the American Medical Association (AMA) released new evaluation and management (E/M) guidelines that simplified the documentation requirements for outpatient E/M services. On the heels...
4 / 23 / 2024

Visit Complexity Add-On Code G2211 FAQs

By
Lori Carlin &
Angela Wood &
Alysia Delozier
Recently, we have been getting questions about the new Healthcare Common Procedural Coding System (“HCPCS”) code G2211 (Visit complexity inherent to evaluation and management associated with medical care services...
4 / 17 / 2024

National Correct Coding Initiative (“NCCI”) Manual: Bonus Article – Billing Bilateral Procedures

By
Lori Carlin &
Angela Wood
If you have questions about how to properly bill Medicare for bilateral procedures, the National Correct Coding Initiative (“NCCI”) policy manual has your answers. Starting on page 30 of...
4 / 3 / 2024

National Correct Coding Initiative (“NCCI”) Manual: Part Three – Add-On Code Edits

By
Lori Carlin &
Angela Wood
In this series of articles on the National Correct Coding Initiative (“NCCI”) Policy Manual, we have discussed procedure to procedure (“PTP”) edits and medically unlikely edits (“MUE”), but were...
3 / 28 / 2024

AHEAD Model: The Latest Innovation in the Shift to Value-Based Care

By
Kelly Conroy &
Daniela Yusufbekova &
Allison Carty
Introduction & Background  Following the enactment of the Patient Protection and Affordable Care Act (PPACA) in March 2010, the healthcare industry has experienced a major shift in its reimbursement...
3 / 26 / 2024

National Correct Coding Initiative (“NCCI”) Manual: Part Two – Medically Unlikely Edits

By
Lori Carlin &
Angela Wood
In part one we discussed procedure to procedure (“PTP”) edits. In this article we will discuss Medically Unlikely Edits (“MUEs”). The Centers for Medicare and Medicaid Services (“CMS”) defines...
3 / 21 / 2024

March is Kidney Awareness Month!

Introduction March is Kidney Awareness Month, and Pinnacle wants to share updates regarding the new conversion from v24 to v28.  What better way to celebrate than to brush up...
3 / 19 / 2024

National Correct Coding Initiative (“NCCI”) Manual: Part One – Procedure to Procedure Edits

By
Lori Carlin &
Angela Wood
In the introduction, we discussed the three (3) edit types that make up the National Correct Coding Initiative (“NCCI”). Probably the most familiar of those edits are the procedure...
3 / 14 / 2024

National Correct Coding Initiative (“NCCI”) Manual: The Ultimate Medicare Billing Toolkit

By
Lori Carlin &
Angela Wood
One of the best resources we frequently recommend to providers is the National Correct Coding Initiative (“NCCI”) policy manual. It is like using a crystal ball to peer into...
3 / 5 / 2024

PHC 1st Quarter 2024 Real Estate Newsletter

By
Mike Vandaveer
Healthcare Real Estate Transactions Jackson Health Confirms $90 Million Expansion. Jackson Health System has selected Skanska USA as the contractor to complete a $90 million renovation and expansion project that...