Code EMR

11/11/2025

Struggling with delayed payments, rising denials, or growing AR backlogs?

You’re not alone - and the solution starts with understanding Accounts Receivable (AR) Management.

We just released a new video that breaks down how effective AR processes can transform cash flow and strengthen the financial health of your practice.

✅ Monitor aging reports
✅ Follow up on unpaid or underpaid claims
✅ Work denials and rejections
✅ Resubmit corrected claims
✅ Coordinate patient balances
✅ Reduce Days in AR
✅ Prevent write-offs

At CodeEMR, our AR specialists help healthcare organizations improve reimbursement speed, uncover systemic issues like coding errors or payer delays, and maintain a healthier, more predictable revenue cycle.

🎥 Watch the full video here: https://youtu.be/duN1SocoQLI

Accounts Receivable (AR) management is one of the most important components of a healthy revenue cycle. In this video, CodeEMR breaks down how AR management ...

11/06/2025

Did you know?

The DOJ recovered $2.7 billion under the False Claims Act in FY2023, with over $1.8 billion linked to healthcare fraud alone.

As enforcement tightens in FY2024, certified medical coders are more critical than ever in ensuring compliance and preventing costly claim denials.

✅ Accurate coding
✅ Regulatory compliance
✅ Reduced risk of FCA violations

At CodeEMR, we deliver precision-driven medical coding services backed by certified professionals and specialty-specific expertise.

💡 Discover how certified coders can protect your practice from legal and financial risks:

👉 Read the full blog - https://www.codeemr.com/fy2024-false-claims-act-certified-medical-coders/

False Claims Act settlements exceeded $2.9B in FY2024. Learn why certified medical coders are essential for accurate billing, compliance, and fraud prevention.

11/03/2025

Why Code Linkage (Diagnosis Pointer) Matters?

Each CPT (procedure) code that you bill must be linked to the correct diagnosis code that explains why the service was performed. This connection is called code linkage or sometimes a diagnosis pointer on the claim form.

Think of it this way:

• The CPT code tells the insurance company what you did (the service).
• The ICD-10 diagnosis code tells them why you did it (the reason or medical necessity).
• The linkage is what connects those two pieces of information together.

If they don’t match up correctly, the insurance company may deny the claim because they don’t see a medical reason for that service.

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Example:

Let’s say a patient comes in with a sore throat.

• Diagnosis code: J02.9 (Acute pharyngitis, unspecified)
• CPT code: 87880 (Rapid strep test)

If you link 87880 to J02.9, it makes sense - the sore throat supports the need for a strep test.

*Claim likely pays.

But if by mistake, you link 87880 to a diagnosis like E11.9 (Diabetes), it doesn’t make sense to the payer.

*Claim likely denies - no medical necessity.

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Key Points to Remember

• Each CPT must be linked to the correct diagnosis that justifies the test or procedure.
• Some visits may have multiple diagnoses and multiple CPT codes - make sure each one is linked to the proper “why.”
• Accurate linkage helps reduce denials and supports compliance.
• “If it wasn’t medically necessary, the insurance won’t pay - and if it was necessary, the linkage must show it.”

Contact us today - https://www.codeemr.com/request-information/

10/30/2025

🔍 Understanding HCC Coding: A Key to Accurate Reimbursement and Quality Care

In the era of value-based care, accurate documentation and coding are paramount. Hierarchical Condition Category (HCC) coding plays a crucial role in determining reimbursement rates by assessing the severity of a patient's health conditions.

Why HCC Coding Matters:

1. Fair Reimbursement: Ensures providers are compensated appropriately for managing complex patients.

2. Regulatory Compliance: Adherence to CMS guidelines reduces audit risks and penalties.

3. Quality of Care: Accurate coding supports effective care coordination and population health management.

The Risks of Inaccurate HCC Coding:

1. Revenue leakage from underreported chronic conditions.
2. Audit risks due to unsupported or suspect codes.
3. Gaps in care when patient risk isn't fully understood.
4. Increased administrative workload to correct coding errors.

How CodeEMR Supports HCC Coding:

1. Annual Recapture: Ensuring chronic conditions are coded every year to protect Risk Adjustment Factor (RAF) scores.
2. Provider Education: Collaborating with providers to improve documentation practices.
3. Compliance-First Process: Regular audits and adherence to CMS guidelines to mitigate risks.
4. Scalable Support: Tailored solutions for practices of all sizes.

Accurate HCC coding is more than just a coding task; it's a strategic approach to ensuring fair reimbursement and delivering high-quality patient care.

🔗 Read the full blog here - https://www.codeemr.com/an-introduction-to-hcc-coding-and-why-it-matters/

HCC coding is essential for accurate risk adjustment and reimbursement. Learn how proper documentation and ICD-10 coding impact healthcare revenue and compliance.

10/27/2025

📊 Why Accurate HCC Coding Matters More Than Ever

In today’s value-based care environment, Hierarchical Condition Category (HCC) coding isn't just about checking boxes - it's about capturing a patient's full clinical picture to ensure accurate risk adjustment and maximum reimbursement.

⛔ Inaccurate coding can lead to:
• Revenue loss
• Audit risks
• Skewed patient risk scores

✅ In this blog, we break down how accurate HCC coding helps healthcare organizations:
• Optimize reimbursements
• Improve care quality
• Stay compliant with CMS guidelines

💡 Whether you're a provider, coder, or administrator, this guide is a must-read: https://www.codeemr.com/hcc-medical-coding-accuracy-risk-adjustment/

Enhance HCC medical coding accuracy and risk adjustment outcomes with proven strategies that improve compliance, patient care, and value-based healthcare success.

10/23/2025

💡 Did you know?

Community Health Centers (CHCs) and Federally Qualified Health Centers (FQHCs) face some of the most complex coding and reimbursement challenges in healthcare.

From encounter-based PPS billing and preventive care visits to behavioral health and telehealth coding - accuracy isn’t just important, it’s essential for financial sustainability.

In our latest blog, we explore how CodeEMR’s specialized CHC & FQHC coding support helps centers:

✅ Reduce denials and accelerate reimbursements
✅ Maintain PPS and compliance accuracy
✅ Scale operations without increasing overhead
✅ Refocus staff time on patient care, not paperwork

Read how expert coding can strengthen mission-driven healthcare ⬇️

👉 https://www.codeemr.com/coding-support-for-chcs-and-fqhcs/

Improve coding accuracy and compliance for CHCs and FQHCs with CodeEMR’s experts. Streamline workflows, reduce claim denials, and maximize healthcare revenue.

10/20/2025

Coding tip Week 16: Telephone Visits: When you can (and Can’t) Bill for Them

Telephone visits can be a valuable way to connect with patients, especially when an in-person appointment isn’t necessary. But not every call qualifies for billing. To stay compliant and avoid denials, it’s important to know exactly when you can bill for these encounters - and when you can’t.

Below, we break down the key scenarios.
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When Telephone Visits Are Billable
1. The patient initiates the call, and it’s medically necessary.
• Billing requires that the patient request the service, and providers must document both medical necessity and the duration of the call.
2. No related E/M service was billed in the past 7 days.
• Telephone visits must be independent encounters. If a related E/M visit was billed within the last week, the call is considered part of that service.
3. The call does not result in an in-person visit within 24 hours.
• If the phone conversation leads to a face-to-face appointment, the call is bundled with that visit and not separately billable.
4. The call lasts at least 5 minutes.
• Anything shorter does not meet the minimum time threshold required for billing.
5. The provider gives clinical assessment, management, or decision-making.
• To bill, documentation must show that medical decision-making occurred, along with the time spent on the call.
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When Telephone Visits Are Not Billable
1. Call occurs within 7 days of a related E/M service.
• These calls are bundled into the original visit and not separately reimbursable.
2. Call leads to an in-person visit within 24 hours (or the next available appointment).
• Considered pre-service work and included in the resulting visit.
3. The patient did not request the call.
• Telephone visits must be patient-initiated. Provider-initiated calls do not qualify.
4. The call is administrative only.
• Examples include scheduling, prescription refills, or other tasks without medical necessity or clinical evaluation.
5. The call is solely to review lab results.
• Without medical decision-making, these calls don’t qualify for billing. Additionally, they may fall under the “within 7 days of a visit” rule.
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The Bottom Line
To bill for a telephone visit, it must:
• Be patient-initiated
• Involve medical necessity
• Meet the time requirement (≥ 5 minutes)
• Include clinical assessment or decision-making
• Be independent of recent or upcoming visits

Sticking to these guidelines ensures compliance and helps avoid claim denials.

Schedule a free consultation today - https://www.codeemr.com/request-information/

Request information about outsourcing medical coding services with CodeEMR. Our remote coders ensure fast chart processing and improved revenue cycle efficiency.

10/16/2025

💡 Did you know?

Accurate HCC (Hierarchical Condition Category) coding plays a critical role in determining reimbursement, ensuring risk adjustment accuracy, and reflecting the true complexity of patient care.

In value-based care models, even a single missed or inaccurate diagnosis code can lead to underpayments and compliance risks.

In our latest blog, we break down:

1) Key HCC coding guidelines every provider and coder should know
2) Common documentation errors that impact reimbursements
3) Why annual recapture of chronic conditions is crucial
4) How accurate coding strengthens compliance and audit readiness

📖 Read the full blog to know more: https://www.codeemr.com/hcc-coding-guidelines/

Comprehensive HCC coding guidelines for risk adjustment and medical coding, helping providers ensure accurate documentation, compliance, and optimal reimbursement.

10/13/2025

💬 Client Testimonial Spotlight

“CodeEMR has been an incredible addition for our clinic team. Their Medicare and Commercial Payor coding has helped to increase accuracy, reduce internal staffing burden, and improve provider education. We are grateful for a responsive partner that aids us in our efforts to improve quality, coding, and ultimately patient care.”

At CodeEMR, we take pride in being more than just a medical coding service - we’re a trusted partner helping healthcare organizations enhance accuracy, reduce administrative strain, and support better patient outcomes.

✨ Accurate Coding | 📊 Optimized Workflows | 👩‍⚕️ Better Patient Care

Contact us today - https://codeemr.com/request-information

Request information about outsourcing medical coding services with CodeEMR. Our remote coders ensure fast chart processing and improved revenue cycle efficiency.

10/09/2025

Why Outsourcing Medical Billing Makes Sense for Healthcare Practices

Running a clinical practice isn’t just about patient care - managing the revenue cycle effectively is equally critical. In our latest blog, we explore how outsourcing medical billing can be a strategic move to:

1. Reduce administrative burden
2. Improve revenue flow and faster reimbursements
3. Tap into certified experts and compliance support
4. Scale flexibly without the overhead of in-house staff
5. Maintain transparency through robust reporting and KPIs

At CodeEMR, our goal is to partner with providers so they can focus on what matters most - delivering quality care, while we optimize the billing, claim management, and coding workflows behind the scenes.

📖 Read the full blog here → https://www.codeemr.com/why-outsourcing-medical-billing-services/

Outsourcing medical billing services enables healthcare practices to reduce costs, improve claim accuracy, and maximize revenue while focusing on patient care.

10/02/2025

💡 Did you know? Even minor coding errors in urgent care - like misapplied E/M levels or missed after-hours codes - can lead to denials, lost revenue, and compliance risks.

Urgent care centers run at a fast pace, and coding accuracy is often overlooked. That’s why we put together a guide on Urgent Care Coding Best Practices.

In this blog, we share:
🔹 Key coding elements every urgent care must capture
🔹 Common mistakes that trigger denials
🔹 How CodeEMR’s certified coders ensure accuracy, compliance, and revenue integrity

Correct coding = cleaner claims, stronger revenue, and more time for patient care.

📖 Read the full blog: https://www.codeemr.com/2026-icd-10-cm-coding-guideline-updates-fqhc-providers/

Explore the 2026 ICD-10-CM coding guideline updates. Learn how FQHCs and healthcare providers can ensure compliance, improve coding accuracy, and boost revenue.