Category: Medical Coding

Top Strategies to Prevent Medical Billing and Coding Errors

Medical coding and billing errors are a persistent headache for healthcare providers, costing them time, money, and reputation. Studies show that a staggering percentage of medical bills contain errors, leading to denied claims, delayed payments, and frustrated patients. Focus on Prevention: Top coding and billing Errors to Avoid Non-Covered Charges: Verify insurance coverage before rendering […]
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compliant coding and billing

Compliant Coding and Billing for Physicians: Expert Tips

The article explores common billing mistakes and offers tips for four healthcare services that can cause payment headaches for physicians. 1. Annual Wellness Visits vs. Physicals: Understanding Medicare Requirements Differentiating between Annual Wellness Visits (AWV) and Initial Preventive Physical Exams (IPPE) is crucial for accurate billing. Both are covered by Medicare for preventive care, but […]
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chronic migraine with aura

2024 ICD-10-CM Update Enhances Chronic Migraine

The good news for coders is that the 2024 ICD-10-CM update allows for more specific coding of chronic migraine with aura, improving accuracy and potentially helping patients access treatment. Diagnosing Migraine: A Complex Puzzle While the International Headache Society defines chronic migraine, pinpointing the exact type can be challenging. Migraines come in various forms, and […]
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Telehealth coding

Master Telehealth Coding: A Guide to Reimbursement and Avoiding Denials

Navigating the complexities of telehealth coding is crucial for ensuring that services are properly reimbursed. This guide provides essential information and tips for coding telehealth services accurately, helping physicians avoid denials and recoupments. 1. Telephone Services: Use Cases: Suitable for straightforward problems like simple rashes, asymptomatic coughs, and medication refills. Requires a minimum of five […]
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medical-coding-compliance-strategy-to-reimbursement

3 Coding Compliance Strategies to Improve Reimbursement, Quality

The Crucial Role of Medical Coding Compliance in a Value-Based World: Telling the Patient’s Story for Better Billing and Quality Care. Medical Coders: The Unsung Storytellers of Healthcare Medical coders play a critical role in hospitals, but their importance often goes unnoticed. They’re the storytellers behind the scenes, analyzing patient records, selecting billing codes, and […]
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Medical coding Audits

Medical Coding Audits: Trends and Guide for Providers

The landscape of medical coding audits is constantly evolving.  Staying informed about these trends and implementing best practices can significantly reduce stress and ensure a smooth audit experience. The Shifting Landscape of Medical Coding Audits Traditionally, medical coding audits felt like a lottery. Providers faced the uncertainty of random reviews, often scrambling to address issues […]
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CPT Modifier

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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Medical coding guide

14 Things To Know About Medical Coding

In this blog, you should know why healthcare providers need to be aware of the medical coding guide. 1. What is Medical Coding? Medical coding is the process of translating medical diagnoses, procedures, and services into universal alphanumeric codes for proper documentation and billing purposes. 2. Importance of Accuracy: Accurate medical coding is crucial for […]
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modifier 58 vs modifier 78

Modifier 58 Versus 78 – Which Should You Use?

Modifier 58 vs Modifier 78: Key Takeaway: Modifier 58: Same underlying condition, planned or unplanned additional procedure. Modifier 78: New problem caused by the initial surgery (complication) requiring a return to the OR. Medical Coders often struggle to differentiate between modifier 58 (staged/related procedure) and modifier 78 (unplanned return to OR). Let’s break down the […]
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