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GroupOne Health Source Blog

GroupOne Revenue Cycle Blog 

Insights to guide your practice.

 

UnitedHealthcare Will No Longer Reimburse for Consultation Services

by Kaitlyn Houseman on May 17, 2019

UnitedHealthcare (UHC), one of the nation's largest Medicare Advantage plan providers, has announced that it will no longer reimburse CPT® codes 99241-99255. UnitedHealthcare will take a phased approach to the change in the consultation services policy. According to UHC, the change aligns UnitedHealthcare with the Centers for Medicare and Medicaid Services (CMS) to end reimbursement codes for consultation services.

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Topics: Revenue Cycle Management, Medical Coding

A Review of the CMS 2019 Physician Fee Schedule and Quality Payment Program Final Rule

by Kaitlyn Houseman on November 13, 2018

The release of the Centers for Medicare and Medicaid Services' 2019 Physician Fee Schedule and Quality Payment Program final rule offered dramatic improvements for clinicians and patients. CMS is expanding the list of Medicare-covered telehealth services while also focusing on finalizing an overhaul of EHR requirements to promote interoperability. According to a CMS fact sheetCMS finalized several items designed to reduce the regulatory burden on physicians, effective January 1, 2019.  However, the controversial streamlined payment rates will be postponed to 2021 after an overwhelming amount of concern was expressed from the medical community.

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Topics: Revenue Cycle Management, Medical Coding, MACRA

A Complete Guide to the 2019 ICD-10-CM Code Updates

by Kaitlyn Houseman on October 11, 2018

The Centers for Medicare and Medicaid Services (CMS) and the National Center for Health Statistics (NCHS) released the 2019 ICD-10-CM code changes earlier this year. These codes are to be used from October 1, 2018 to September 30, 2019. With hundreds of changing, preparing for the 2019 ICD-10-CM code updates can seem overwhelming. In this post, we'll cover some of the changes taking place and share our comprehensive ICD-10-CM code guide to help you navigate all of the coding changes.

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Topics: Revenue Cycle Management, Medical Coding

A Review of the 2018 CPT Code Set Updates

by Kaitlyn Houseman on December 14, 2017

The new year is almost here meaning it is time for new Current Procedural Terminology (CPT) code changes! The 2018 CPT code set comes with a number of changes that may affect claims processing so it's time to start reviewing which codes affect your practice in order to prevent revenue cycle management disruptions. 

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Topics: Medical Coding

New Year, New Codes: 2017 CPT Code Changes Now Available

by Kaitlyn Houseman on December 20, 2016

2017 is just around the corner and with it comes a number of new CPT codes, deleted codes, and code revisions. The updates made enable providers to get paid for some work that is already being done while other updates remove barriers to providing certain services such as Chronic Care Management.

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Topics: Revenue Cycle Management, Medical Coding

The Basics of Medical Code Bundling and CPT Modifiers

by Kaitlyn Houseman on August 30, 2016

Managing a healthcare practice comes with a long list of complex challenges that need to be solved on a daily basis. Anyone who is involved in the operational aspects of a medical office or healthcare facility understands that there are many situations that require making educated and rule-based decisions based on a variety of factors. Medical code bundling and the use of modifiers is one of them.

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Topics: Revenue Cycle Management, Medical Coding

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