Tag: Physicians

Six Tips to Getting Paid for CPT Modifiers

Six Tips to Getting Paid for CPT Modifiers

In medical coding, CPT modifier are vital for accurate reimbursement of healthcare services. These special codes, attached to primary procedure codes, provide additional details about the complexity or extent of a service. However, using modifiers incorrectly can lead to claim denials and lost revenue. This blog post shares six key tips to help you get […]
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ICD-10-CM Codes for Diabetes Mellitus Symptoms

ICD-10-CM Codes for Diabetes Mellitus Symptoms

In 1991, International Diabetes Federation (IDF) & World Health Organization (WHO) combine to create World Diabetes Day (WDD) on November 14 and we take this day to spread awareness and education on Diabetes, a chronic disease where pancreas won’t produce enough insulin which leads to serious health issues. Many physician and health providers will struggle […]
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CPT Code Set Released for the year 2023

CPT Code Set Released for the year 2023

The American Medical Association (AMA) says the 2023 CPT code updates emphasize its efforts to reduce administrative tasks. The AMA released the calendar year 2023 CPT code set, which builds on the AMA’s efforts to reduce administrative tasks in medicine, according to a recent press release. The CPT code update contains 393 changes, including 225 […]
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Professional Fee Revenue Cycle for Better ED Bottom Lines

7 Best Practices to Improve Professional Fee Revenue Cycle for Better ED Bottom Lines

Most healthcare organizations partner with physician services groups for niche coverage. While outsourced medical services are available across all specialties, common areas for external physician support include anesthesia, radiology, wound care, and emergency medicine. However, when outsourced physician services are used, challenges to ensure accurate reimbursement for both components of care—the hospital portion and the […]
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Pain Management and The Global Period

Pain Management and The Global Period

Pain management during the global period of a procedure, if related to that procedure, is not separately reportable. If a provider other than the operating provider performs follow-up care, you must be careful to avoid “unbundling” of that follow-up care. The global period, or global surgical package, bundles all care typically related to surgical service into a […]
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A Rebeginner Guide to Peer-to-Peer Appeals

A Rebeginner’s Guide to Peer-to-Peer Appeals

Suggestions for conducting peer-to-peer appeals for denials. If you are wondering why you should read this if you think you are not a rebeginner, well, it is because you actually are one. Beginnings do not disappear, they just reproduce. Novices are just starting, veterans have started over and over. We all begin as beginners and […]
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Diagnostic Accuracy

ICD-10, Diagnostic Errors & Payment Reforms to Improve Diagnostic Accuracy

In October 2015, physicians across the United States transitioned from the International Statistical Classification of Diseases and Related Health Problems, Ninth Revision to the tenth revision (ICD-10-CM, the US version of the World Health Organization [WHO] ICD-10). Although the ICD-10-CM was a new concept for physicians in the United States, the international variant has been available since […]
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Federal Policy to End Surprise Billing

Federal Policy to End Surprise Billing: Building on Prior Approaches

Ending surprise medical bills has risen to a national priority with bipartisan political interest. In January, President Donald Trump directed Cabinet officials to find a solution, and multiple congressional bills were proposed in the last Congress with the same goal. Surprise medical bills consist of unanticipated charges from out-of-network clinicians—often when the facility or primary physician is […]
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Chronic Condition

Chronic Conditions: Code or Not to Code MCCs

  Understanding the correct use of chronic condition codes in the coding process. Unexpected and inaccurate medical bills can be alarming and shocking. Coders are often confused regarding when they should code co-morbid chronic conditions and when they should not. This leads to inaccurate coding of levels, or sometimes missing out on the opportunity of […]
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