Tag Archives: medical coding services

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 […]

Out-of-Network COVID-19 Test Cost is higher than the commercial price

Out-of-Network COVID-19 Test Cost is higher than the commercial price

According to a new report provider prices for out-of-network COVID-19 tests are higher than the average cost of in-network tests. America’s Health Insurance Plans (AHIP) is calling on the government to stop price gouging after finding provider prices for out-of-network COVID-19 tests far exceeded the average cost of in-network tests. In a report released late […]

Fundamentals to avoid Claims Denials

Fundamentals to avoid Claims Denials

For any practice, reducing the claims denials can put them on the path to increase in reimbursement. Your staff or outsourced billing company often sees the word “claim denied”, which leads to increased work and less revenue for your practice over a time. American Medical Association study found that many medical practices spend thousands of […]

How to get success in risk-based payment model

How to get success in a risk-based payment model?

Reimbursement insufficiency, data on time, and most important data access are preventing hospitals and health systems from moving to risk-based payment, according to a recent survey from healthcare improvement company Premier. What is a risk-based payment model? According to American Academy of Pediatrics, There are a variety of risk-based or budget-based payment models being developed. […]

Revised Evaluation and Management Codes in 2021

Revised Evaluation and Management Codes in 2021

The American Medical Association (AMA) strongly disagreed, and the AMA’s CPT® panel got to work on revisions. It takes time to revise CPT® codes and definitions., but the CPT® editorial panel made changes in 2019 that will take effect in 2021. There wasn’t time to put these changes in the 2020 book, and the guidelines […]

Inpatient Psychiatric Facilities Prospective Payment System

FY 2021 Inpatient Psychiatric Facilities Prospective Payment System (IPF PPS)

The CMS is finalizing a rule that further advances our efforts to support the Medicare program by better aligning payments for inpatient psychiatric facilities (IPFs) with the costs of providing care. The final rule will update Medicare payment policies and rates for the IPF Prospective Payment System (PPS) for FY 2021. These policies will help […]

Coding Updates for General Surgery

Coding Updates for General Surgery

Multiple changes in the Current Procedural Terminology (CPT) coding expected to impose in 2020. Following are the coding updates, which are applicable to general surgery and similar specialties for the year 2020. Coding Updates for General Surgery General Surgery New Graft Codes The code 20929, Tissue grafts, other (e.g. fat, dermis, paratenon) has been misvalued, […]