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Mastering DMEPOS Coding: Overcoming HCPCS Challenges

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Accurate coding is the backbone of medical billing and reimbursement. However, when it comes to Durable Medical Equipment, Prosthetics, Orthotics, and Supplies – Assigning the Correct Code , things can get complicated. The AMA CPT Manual does not cover DMEPOS, and while the HCPCS Manual does, it lacks clear coding guidelines. This creates confusion for coders, compliance officers, and revenue cycle management teams who must ensure correct claim submission. Why Is DMEPOS Coding So Challenging? Unlike procedural and diagnosis coding, DMEPOS coding often lacks clear-cut instructions. Several factors make it difficult: Limited Medicare NCCI Edits – Many edits are proprietary and unpublished, leaving coders with minimal guidance. Ambiguous HCPCS Manual Guidelines – The manual includes codes but does not always specify how they should be applied. Multiple Sources of Coding Guidance – From LCDs to PDAC and manufacturer recommendations, there is no single reference for DMEPOS coding. Modifi...
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Emergency Preparedness: Organizing Hospitals for Seasonal Virus Outbreaks in the USA

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  Outbreaks of infectious disease, disasters, and conflict have reminded the world of the reality that it is still prone to health emergencies with global consequences. Significant gaps still exist in the ability of many countries to address all hazards, health emergencies, and disaster risks. WHO has played an increasingly operational role in the past few years. Ongoing conflict and inadequate health systems mean that many countries cannot provide the most basic health, nutrition, and social services. It is in these vulnerable settings where most deaths among children under five occur, as well as the highest rates of maternal mortality, unintended pregnancy, sexual and gender-based violence, malnutrition, mental disorders, underimmunisation, and infectious disease outbreaks. Conflict, climate change, population growth, and movements are changing the context in which we operate. An estimated 1.4 billion people live in fragile, conflict-affected, and vulnerable settings. Eighty perc...
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What is the non-compete law in New York 2024?

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  What is the non-compete law in New York 2024? Non-compete agreements are legally binding agreements that some employers impose on their employees to restrict them from working for a competing company for some time after leaving the job. Given that Employees who signed non-competes are unlikely to leave because the legal agreement limits their mobility, the classic non-compete components included preventing the complaining party from obtaining a trade secret or a customer relationship for a specific amount of time. The current global picture regarding litigation of non-compete has started to change. Recent proposals, such as Assembly Bill A1278, targeting further restrictions on the use and the enforcement of non-compete, will potentially decrease further legal battles on whether a non-compete can be enforced or not. The law would make it illegal for businesses to counteroffer without the approval of the Ministry of Economy. It would ban the use of non-compete clauses for most emp...
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Be Aware of ICD-10-CM Code 2025 Guideline Changes

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  The updates to the ICD-10-CM Official Guidelines for Coding and Reporting are minimal for 2025. Most of the updates are necessary to maintain consistency in how things are referenced in the guidelines based on the addition of new codes. The International Classification of Diseases 10th revision clinical modification is adapted from time to time to keep up with the changes in the University's clinical practice, the development of new diseases, and the changing of relevant regulatory guidelines. The updates of codes of ICD-10-CM Code updates 2025 are many and significant for healthcare practitioners and medical coders to learn in order to document correctly, optimally reimburse, and comply with regulations. Key Changes in ICD-10-CM Code Updates 2025 include but are not limited to: Expansion of diagnosis codes The updated codes for the year 2025 include 500 plus additional codes, which will include all known emerging diseases and conditions, for example, The code's long-term com...
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Mastering The 2024 Prior Authorization Process For Medical Providers

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  Mastering The 2024 Prior Authorization Process For Medical Providers Prior Authorizations are a cost containment strategy that third-party payers leverage to control costs, restrict patient access to services, testing, and medications, and ultimately discourage medical providers from ordering unnecessary medical treatment. Prior authorizations are a major source of headaches for healthcare providers nationwide. Despite the intention to control costs and ensure appropriate care, the prior authorization process has been criticized for its enormous administrative burden, potential delays in necessary medical treatment, and added complexity for healthcare providers. Striking a balance between cost control and efficient patient care remains a major challenge in the healthcare industry. Join us for an insightful 60-minute webinar as we take a deep dive into the complexities of the Prior Authorization process, discuss the pearls and pitfalls, define medical necessity requireme...
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Credentialing 101: Detailed Guide to Provider Credentialing + Maintaining Provider Enrollments, Updates, and Re-Validations

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Credentialing 101: Detailed Guide to Provider Credentialing +  Maintaining Provider Enrollments, Updates, and Re-Validations
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CMS Hospital QAPI Standards 2024 Updates

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CMS Hospital QAPI Standards 2024
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