Tag Archives: medical coding services

Patients’ Electronic Access to Health Information

Patients’ Electronic Access to Health Information

CMS Rule Building on the CMS Interoperability and Patient Access final rule (CMS-9115-F), this proposed rule would place new requirements on Medicaid and CHIP managed care plans, state Medicaid and CHIP fee-for-service programs, and Qualified Health Plans (QHP) issuers on the Federally-facilitated Exchanges (FFEs) to improve the electronic exchange of health care data, and streamline […]

OIG Targets Ambulance Transportation Services for Incorrect Medicare Billing

OIG Targets Ambulance Transportation Services for Incorrect Medicare Billing

In a recent round of demands it has initiated, the HHS Office of Inspector General is targeting ambulance transportation services even as services continue to struggle financially during the pandemic. OIG is now seeking financial damages from ambulance services that may have transported patients during a Part A stay from a qualified nursing facility. Legal […]

How to improve medical billing accuracy in CY 2021

How to improve medical billing accuracy in CY 2021?

The medical billing and coding process is a complex. When a patient presents with a significant medical history or complicated case billing can be time-consuming taking days, or months, to finalize. On top of that recent amendments to the U.S. healthcare system have added a variety of new challenges for both providers and patients. Various […]

When is it appropriate to use modifier 90?

When is it appropriate to use modifier 90?

Reference (Outside) Laboratory When laboratory procedures are performed by a party other than the treating or reporting physician, the procedure may be identified by adding the modifier 90 to the usual procedure number. Modifier 90 should be appended to the procedure code representing the laboratory service that is being submitted to an outside laboratory for […]

What is advance beneficiary notice in medical billing

What is advance beneficiary notice in medical billing?

An advance beneficiary notice is a written notice (standard government form CMS-R-131) from Medicare, given to patient before they receive certain equipment or services, notifying patient that: Medicare may not provide reimbursement for that specific procedure or treatment Patient will personally responsible for complete payment if Medicare decline payment An ABN provide an opportunity to […]

Chiropractic CPT Codes

Chiropractic CPT Codes

Benefits of Chiropractic Insurance Billing When looking to increase your client base, your practice should be in-network with insurance this can help you reach new patients.  Patients looking for a new provider will often turn to their coverage to find who is going to accept their insurance. You will come up as an in-network provider, […]

What is a modifier 53 mean?

What is a modifier 53 mean?

Modifier 53 could almost be stated to as a forgotten modifier; practices forget or just never find out how to appropriately use it. This is often partially because there’s no set definition for ‘extenuating circumstances,’ leaving it susceptible interpretation and diminishing appropriate use. It’s especially unfortunate how disused modifier 53 is, because by not using […]

CPT Code 99072

CPT Code 99072

Current Procedural Terminology Code 99072 Reporting: Additional supplies, materials, and preparation time required and provided by the physician or other qualified health care professional and/or clinical staff over and above those usually included in an office visit or other service(s), when performed during a nationally declared public health emergency due to respiratory transmitted infectious disease. When reporting […]