Tag: Medical Billing

KX Modifier

KX Modifier: Description, Correct Usage, Examples & Documentation Requirements

In the complex world of medical billing and coding, modifiers play a crucial role in ensuring claims are processed accurately and providers are reimbursed correctly. One such modifier that often causes confusion is the KX Modifier. Knowing when and how to use this modifier can make a significant difference in compliance, reimbursement, and avoiding denials. […]
CPT Code 95816-Allzone

Navigating CPT Code 95816: A Comprehensive Guide to ECoG Billing

In the complex world of medical billing and coding, accuracy is paramount. CPT Code 95816, which covers “Electrocorticography (ECoG) under anesthesia or sedation,” is a critical code for neurologists and neurosurgeons. This specialized procedure requires meticulous documentation and precise coding to ensure proper reimbursement and compliance. Given the complexities involved, many healthcare providers are turning […]
CPT Code 90791

Your Essential Guide to CPT Code 90791: Psychiatric Diagnostic Evaluation

In the intricate world of medical billing and coding, understanding specific CPT (Current Procedural Terminology) codes is paramount for healthcare providers and patients alike. Among these, CPT code 90791 holds a significant place, representing a crucial initial step in mental health care: the psychiatric diagnostic evaluation. This comprehensive guide will delve into the nuances of […]
CO 22 denial code

CO 22 Denial Code: Expert Guide to Prevention & Resolution in Medical Billing

In essence, the insurance company you billed believes another insurer is primarily responsible for the payment. Understanding and effectively managing CO 22 denial code is critical for maintaining a healthy revenue cycle and ensuring timely reimbursements. This comprehensive guide will break down the CO 22 denial code, explore its common causes, and provide actionable strategies […]
UB-04 Claim Form

Understanding the UB-04 Claim Form (CMS-1450) in Medical Billing

In the complex world of medical billing, accurate documentation is essential for timely reimbursements and claim acceptance. One of the most critical tools in hospital and institutional billing is the UB-04 claim form, also known as the CMS-1450. Whether you’re a healthcare provider, billing professional, or medical coder, understanding this form is crucial for ensuring […]
Mastering Patient collections

Mastering Patient Collections: 5 Strategies for the New Healthcare Consumer

In today’s rapidly evolving healthcare landscape, one of the biggest challenges facing providers isn’t delivering care—it’s getting paid for it. The traditional methods of collecting patient balances no longer cut it. As the healthcare consumer grows more empowered, informed, and selective, providers must rethink their strategies to improve patient collections. At Allzone Management Services, we […]
G2211 CPT Code Guide to Reimbursement, Billing, and Usage

G2211 CPT Code Explained: Billing Guidelines, Reimbursement, and Modifier Use

 Key Takeaways G2211 is an add-on HCPCS code representing visit complexity tied to ongoing, longitudinal patient care. It must be billed with E/M codes (99202–99215) and cannot be billed independently. Medicare reimburses G2211 (approx. $16 nationally), but commercial payer acceptance may vary. Use accurate documentation to demonstrate the longitudinal care relationship. No modifiers are usually […]
GY modifier

Mastering the GY Modifier: A Guide for Anesthesia Providers

Every code, every modifier, plays a crucial role in ensuring accurate reimbursement for services rendered. For anesthesia providers, understanding and correctly applying modifiers is particularly critical, as their services often involve complex scenarios. Among these, the GY modifier stands out as a powerful, yet often misunderstood, tool for ensuring proper payment for non-covered services. If […]