2024 Medicare Coding Guide: Part 1 – Traditional Medicare

Medical Economics May 31, 2024
Lisa Eramo, MA

Everything you need to know about coding

Part 1: Traditional Medicare

Use internal billing edits to reduce denials

With nearly 67 million people enrolled in traditional Medicare, it’s not surprising that 98% of physicians are participating providers. However, participation doesn’t guarantee payment for services rendered. As with any payer, there are countless rules to follow, and one misstep can cause denials that greatly impact net revenue. Fortunately, there are ways to proactively mitigate the risk of traditional Medicare denials.

“Medicare denials are inevitable. The key to getting ahead of them is having visibility into why they’re denied,” says Toni Elhoms, CCS, CPC, CPMA, CRC, CEO at Alpha Coding Experts in Orlando, Florida.

Practices should pay close attention to denial trends...

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