Category: Blog

prior authorization

8 Useful Insights To Win The Prior Authorization Game

There is nothing more frustrating to physicians than knowing a patient needs a certain diagnostic test or medication and having them not be able to get it because their health insurance company won’t cover it. All too often, many services require prior-authorization (PA). It wouldn’t be so bad if the insurance companies made the guidelines […]
Learn More
Code for Critical Care

The Best Way to Code for Critical Care

Key: Amount of time spent with the patient indicates which code to use. Coding for physician inpatient services, especially critical care, is deceptively straightforward. The reality is that the details of each code requirement can complicate things to the point of complete confusion. Despite the challenges, there are specific strategies you can use to correctly […]
Learn More
3 Coding Tips From Medical Bill Consultants’ CEO

3 Coding Tips From Medical Bill Consultants’ CEO

Beth Morgan, president and CEO of Medical Bill Consultants, has over 40 years of experience coding and billing for various providers and facilities. She provided these three tips: Read the notes carefully. If coders and billers don’t read notes carefully, they might miss a key component that the provider also missed. For example, if the […]
Learn More
New Medicare Cards Are Coming

New Medicare Cards Are Coming

The Medicare Access and CHIP Reauthorization Act (MACRA) of 2015, requires us to remove Social Security Numbers (SSNs) from all Medicare cards by April 2019. A new Medicare Beneficiary Identifier (MBI) will replace the SSN-based Health Insurance Claim Number (HICN) on the new Medicare cards for Medicare transactions like billing, eligibility status, and claim status. The […]
Learn More
Evaluation and Management

Coding for time vs. E/M elements

Q: When you are basing an office visit on time, do you need to meet the levels in history, exam and medical decision-making too? A: It is not unusual to spend a considerable amount of time face-to-face with a patient reviewing problems, adjusting medication dosages and counseling or coordinating care, only to find that you […]
Learn More
functional endoscopic sinus surgery codes

SNF Consolidated Billing Code Updates for 2018

The skilled nursing facility (SNF) consolidated billing (CB) file reflects new codes for 2018, as well as codes that are excluded from SNF CB for Medicare Part A claims payment. The SNF annual update file contains a comprehensive list of codes involved in editing institutional claims submitted to A/B Medicare administrative contractors (MAC) for services […]
Learn More
x