Functional Endoscopic Sinus Surgery (FESS) is a minimally invasive procedure performed endoscopically on the nasal and sinus cavities. It is primarily used to relieve symptoms of chronic sinusitis, such as congestion, drainage, post-nasal drip, headaches, and facial pain. FESS coding can be complex due to the multiple CPT codes associated with the procedure. Reviewing sinus […]
Medical coding and billing are critical components of the healthcare revenue cycle. They ensure that healthcare providers receive proper reimbursement for the services rendered. However, the ever-evolving regulatory landscape, shifting payer policies, and technological advancements present numerous Medical Coding & Billing Challenges. These challenges significantly impact the efficiency and accuracy of the revenue cycle. As […]
Selecting a diagnosis code based solely on intuition is not enough. Each diagnosis must be supported by clear clinical rationale, documented in the care plan, and recorded in the patient’s chart notes. Staying informed about Code Updates for Chiropractic Practices ensures accuracy, compliance, and proper reimbursement for services rendered. Coding Best Practices Symptom vs. Diagnosis […]
Therapy services play a vital role in healthcare, helping patients recover from injuries, manage chronic conditions, and improve overall well-being. To ensure accurate billing and reimbursement, healthcare providers must use the correct therapy services codes. These codes, primarily based on the Current Procedural Terminology (CPT) and Healthcare Common Procedure Coding System (HCPCS), help standardize claims […]
Accurate coding of dermatological procedures requires a deep understanding of skin anatomy and the ability to extract key details from clinical documentation. Over the past two months, we’ve covered Wound repair coding guidelines for skin tag removal, shaving, and lesion excision. Now, in this final installment, we focus on wound repair (closure) procedures using CPT® […]
Clinicians participating in the Making Care Primary (MCP) model now have access to two new HCPCS Level II codes, HCPCS Codes G9037 and G9038, introduced in fiscal year (FY) 2024. These codes expand the scope of interprofessional consultation services, allowing primary care providers (PCPs) to bill for time spent collaborating with specialists. The MCP Model: […]
Medical coding is the lifeblood of healthcare operations. It forms the crucial bridge between patient care and financial reimbursement, ensuring that healthcare providers are compensated for the services they render. However, the complexity and sheer volume of medical codes, coupled with the ever-evolving regulatory landscape, make accuracy a persistent challenge. This is where the potential […]
Value-based care is revolutionizing healthcare delivery, shifting the focus from volume to value. But what exactly does that mean, and how do seemingly technical elements like CPT Codes in Value-Based Care fit into the picture? This blog post dives deep into the world of value-based care, exploring its core components and highlighting the crucial role […]
Stay updated with the latest guidelines for reporting products and procedures related to Chimeric Antigen Receptor (CAR) T-cell therapy to ensure accurate CAR-T therapy coding and billing for Medicare patients. Overview of CAR-T Therapy CAR-T is a cutting-edge cell-based gene therapy that modifies a patient’s own T lymphocytes (T-cells) in a lab to express chimeric […]
The observed an increasing number of denied Evaluation and Management (E&M) claims (99201-99215) when billed concurrently with chiropractic manipulation procedures, including chiropractic manipulative therapy (CMT), highlighting the potential for increased claim denials with Chiropractic Manipulative Therapy (CMT). Denial Reasons & Misconceptions: Common denial reasons include: “Service billed is included in another procedure billed the same […]