Modifiers 52: Professional fee-for-service guidelines for modifiers do not apply in the clinical setting. Reduced, Failed, Aborted, Aborted… which one? What are the requirements for using modifiers 52, 73 and 74? These questions are common in the coding center world, and the answers never seem to be clear. Confusingly mix up the medical code instructions […]
The official April 2024 update to the HCPCS Level II code set is now available on the Centers for Medicare & Medicaid Services website. April update includes: 62 new codes 2 changes to scope and long description 21 obsolete codes 11 changes to long description 1 change to changes miscellaneous changes Below are some code […]
New billing codes: Medical experts might consider creating new billing codes for the time doctors and their support staff spends working on prior authorizations. The American Medical Association (AMA) Current Procedural Terminology (CPT) Editorial Board meets May 9-11 in Chicago. On the meeting’s agenda are three potential new CPT codes “for reporting services (physician, QHP, […]
Explore the intricacies of codes for a better understanding of regulatory compliance in medical coding. Healthcare billing and documentation are based on medical coding. An accurate representation of the patient’s health journey, appropriate reimbursements, and avoiding potential legal pitfalls are crucial to ensuring accurate representation of the patient’s health journey, not just an administrative formality. […]
Preventive Services Vs Office Visits: It is important to note that Medicare does not cover preventive services in the same manner as commercial payers. Therefore, it is important to know the patient’s policy and insurance coverage. Table A shows a breakdown of the coverage parameters. Understanding the distinction between Preventive Services Vs Office Visits is […]
2024 MPFS Final Rule: If you don’t have time to read the final medical fee schedule rule, be sure to read this section. Medicare policies may have a significant impact on all payer policies. Therefore, it is important for anyone working with health insurance claims to be aware of policy changes in the New Year. […]
Medical coding challenges: Medical coding in healthcare is the process of converting complicated medical information into standardized codes that may be used for Medical billing and record keeping. Medical coding presents unique obstacles, even though it is critical for guaranteeing proper compensation and keeping a complete patient history. In this article, we’ll navigate through common […]
The CY 24 MPFS final rule last run the show was disseminated inside the November 16, 2023 Government Select. The run they appear addresses updated installment for specialist and other specialist administrations conjointly sets out unused rulemaking concerning certain other providers and things, such as ambulances, inquiries about offices and other demonstrative offices, and pharmaceutical […]
Medical coding practices’ evolve as the healthcare landscape rapidly transforms with telemedicine leading the way and the proliferation of virtual consultations. In addition to the unique challenges and opportunities presented by these changes, it is also important to remember that optimizing medical coding procedures and ensuring appropriate reimbursements are also unique challenges presented by these […]
The American Medical Association (AMA) Current Procedural Phrasing (CPT)* code set is overhauled every year. This year, numerous of the upgrades are time-based codes, which may influence when they may be detailed. This article depicts CPT 2024 Coding Updates that are pertinent to common surgery and related specialties. Hyperthermic Intraperitoneal Chemotherapy in CPT 2024 Coding […]