Medical Coding and Billing Articles

by Find-A-Code and friends


Subscribe to Find-A-Code's Newsletter

Receive a free email newsletter that includes coding tips, industry news, articles, and information about Find-A-Code updates, improvements and new products.

Subscribe Today

recent articles

Select the title to see a summary and a link to the full article.  some articles require a subscription to view.

Medicare Revises Policy on Home-Based Noninvasive Positive Pressure Ventilation to Treat Chronic Respiratory Failure Due to Chronic Obstructive Pulmonary Disease

by  Wyn Staheli, Director of Content - innoviHealth

RADs with bi-level capability, with or without a backup rate feature, are devices that use a noninvasive interface (mask) to deliver a higher level of airway pressure when the patient inhales compared to when they exhale. A backup rate feature enables the device to provide a prespecified respiratory rate if the patient’s spontaneous respiratory rate decreases below a set number. HMVs deliver a predetermined amount of air with each breath and typically have more monitoring, safety, alarm, and backup power features (such as batteries) than RADs.

OIG Announces New Rules Enforcing Confidentiality of Substance Use Disorder Patient Records

by  Wyn Staheli, Director of Content - innoviHealth

In February 2024, HHS published a final rule modifying the Part 2 regulations to implement section 3221 of the Coronavirus Aid, Relief, and Economic Security (CARES) Act, to increase coordination among providers treating patients for SUDs, strengthen confidentiality protections through civil enforcement, align certain Part 2 requirements with the Health Insurance Portability and Accountability Act of 1996 (HIPAA) Privacy, Security, and Breach Notification Rules, and enhance integration of behavioral health information with other medical records to improve patient health outcomes. The final rule provides the public with the ability to file complaints alleging violations of the Part 2 confidentiality provisions, requires Part 2 programs to provide notification of breaches of Part 2 records, and implements in regulation HHS’s civil enforcement authority, including the potential for civil money penalties for violations of Part 2.

Wound Care: Medicare Audits & The Skin Substitute Surge

by  Knicole C. Emanuel Esq.

Federal contractors – Recovery Audit Contractors (RACs) and Unified Program Integrity Contractors (UPICs) – have increasingly targeted wound care claims, particularly involving expensive skin substitutes billed under Medicare Part B. In 2023 alone, over $1.6 billion was spent on these products, prompting heightened audit activity from Qlarant, Novitas, and others. This...

Ostomy Supplies & Chronic Care Management Services -- MLNConnects

by  CMS - MLNConnects

Ostomy Supplies: Prevent Claim Denials - Chronic Care Management Services — Revised

2025-07-10-MLNC

by  CMS - MLNConnects

Medicare Improperly Paid Suppliers for Intermittent Urinary Catheters - Transcatheter Edge-to-Edge Repair for Tricuspid Valve Regurgitation...

Surgeon Payments in the Crosshairs Following HHS OIG Audit

by  Ronald Hirsch, MD FACP CHCQM CHRI

Today, in utilization news, there is a warning to any surgeons who may be reading this – or anyone who works with surgeons. You may see new efforts by the Centers for Medicare & Medicaid Services (CMS) to lower your fees in coming years. We have all heard about...

2025-06-26-MLNC

by  CMS - MLNConnects

Commodes, Bed Pans & Urinals: Prevent Claim Denials Claims, Pricers & Codes Integrated Outpatient Code Editor Version 26.2 - Medical Education: Don’t Submit Claims for Programs of All-Inclusive Care for the Elderly - MLN Matters® Articles DMEPOS Fee Schedule: July 2025 Quarterly Update Publications...

2025-07-03-MLNC

by  CMS - MLNConnects

CMS Screening, Brief Intervention & Referral to Treatment (SBIRT) Services — Revised; CMS Notifies Individuals Potentially Impacted by Data Incident; CMS Launches New Model to Target Wasteful, Inappropriate Services in Original Medicare

MLNConnects - 2025-06-12

by  CMS - MLNConnects

Mechanical Ventilation: Bill Correctly for Inpatient Claims - SNF Services: Prevent Claim Denials MLN Matters® Articles - Ambulatory Surgical Center...

Measles Coding Considerations

by  Christine Geiger, MA, RHIA, CCS, CRC

Considering the increase in measles cases in the United States and globally, it is a great time to review how we code for this condition. According to Centers for Disease Control and Prevention (CDC) data, updated on May 30, so far this year we have had 1,088 domestic measles...

Medical Coding Haemophilus Influenzae

by  Janine Mothershed

Here's a clear and thorough guide for medical coding and billing for Haemophilus influenzae (H. influenzae) — not to be confused with the flu (influenza virus). This bacterium can cause serious invasive diseases like meningitis, epiglottitis, pneumonia, and sepsis. Common ICD-10 Diagnosis Codes: - A41.3...

What Coders Need to Know: Anticoagulant versus Antiplatelet – Coding Considerations

by  Christine Geiger, MA, RHIA, CCS, CRC

Continuing our look at areas where we see confusion we will examine the assignment of the long term use codes for anticoagulants versus antithrombotics/antiplatelets.  GoodRx.com, in an article titled, “Antiplatelet vs. Anticoagulant Blood Thinners – 4 Things to Know,” details the basics coders need to keep in mind when...

MLN Connects Newsletter

by  CMS - MLNConnects

Walkers: Prevent Claim Denials - Medicare Preventive Services — Revised

Dental Claims Requiring Use of ICD-10-CM Codes

by  Christine Taxin, President - Links2Success

Dental claims now require the use of ICD-10-CM codes. Several states (e.g., Arizona) have begun to mandate that diagnosis codes be reported along with dental codes on claim forms.

Security Risk Assessment Tool Updated

On November 1, 2024, the Office for Civil Rights (OCR) announced the release of their updated Security Risk Assessment (SRA) tool.

Reasons Why Your Attorney Shouldn’t Write a Refund Letter

by  David M. Glaser, Esq.

If your lawyer ever writes you a letter/email telling you to refund money, I recommend you get a new lawyer.  Now, it is very easy to misconstrue what I just said.  I am not suggesting in any shape, way, or form that a lawyer should not recommend that you...

New HIPAA Cybersecurity Rules Proposed

by  Wyn Staheli, Director of Content - innoviHealth

A Proposed Rule has been issued regarding HIPAA security to strengthen protections for electronic protected health information (ePHI). How will these changes impact your organization?

Consumer Health Plan Appeals

As part of the Patient Protection and Affordable Care Act (PPACA) of 2010, expanded appeal rights for patients have been granted in all states. These regulations grant the right to both an internal appeal through the insurance plan, as well as an independent external appeal.

Designation of Authorized Representative for Appeals

A Designation of Authorized Representative is a formal document (form) that allows a third party, such as a friend, family member, attorney, or healthcare provider, to act on behalf of the patient/beneficiary in handling specific aspects of an insurance claim or appeal

Managed Care Organizations (HMO, PPO, etc.)

Managed care is a type of health insurance system designed to reduce healthcare costs while ensuring high quality care through coordinated, cost-effective, and efficient delivery of services. Learn the characteristics of these types of programs.


articles by month

   



Past articles

Many of the following articles have been tagged with the tags shown above. These are displayed here again for historical purposes.

The following articles are published here and elsewhere on the Internet. If you would like to publish one of these articles on your website, please contact us and let us know which article you would like to publish and where you will be publishing it.

Articles: ICD-10

Articles: Medical Coding

Articles: Medical Billing

Articles: Medical Billing and Coding (General)



article requests

If you would like a specific article written on a medical coding and billing topic, please contact us.

contact

innoviHealth Systems, Inc.
62 East 300 North
Spanish Fork, UT 84660
Phone: 801-770-4203 (8-5 Mountain)
Email: info@findacode.com
demo
request yours today
subscribe
start today
newsletter
free subscription

Thank you for choosing Find-A-Code, please Sign In to remove ads.