Tag: healthcare coding

Reducing Claim Denials

Mastering Healthcare Claim Denial Management: Strategies & Solutions

In healthcare, claim denials pose a significant challenge to a provider’s revenue cycle. Each year, over $4.5 trillion in claims are submitted to insurance carriers in the U.S. alone. Despite this volume, healthcare providers continue to see an alarming rise in denied claims. In 2022, 42% of respondents reported an increase in denials, but by […]
Learn More
Urology Billing and Coding

Urology Billing & Coding Errors and How to Prevent Them

Urology practices face unique challenges when it comes to billing and coding. The complexity of urological procedures, coupled with ever-changing coding guidelines, can lead to costly errors, claim denials, and revenue loss. Accurate and efficient billing is crucial for the financial health of any urology practice. This blog post will delve into common urology billing […]
Learn More
Medical coding challenges

2025 Coding Challenges: Strategies for Success

It is predicted that the healthcare industry will continue to evolve rapidly as we enter 2025. Medical coding, one of the cornerstones of healthcare administration, faces unique Coding challenges that require innovative strategies to succeed. For organizations to maintain accuracy, compliance, and efficiency, it is imperative to stay current with the changing regulations, technological advances, […]
Learn More
Healthcare Coding updates

2025 CPT, ICD-11, and HCPCS Updates: A Guide for Providers

Healthcare providers need to stay informed about Healthcare Coding Updates to the Current Procedural Terminology (CPT), International Classification of Diseases (ICD-11), and Healthcare Common Procedure Coding System (HCPCS) in the ever-evolving world of medical coding and billing. To ensure accurate coding and maximize revenue cycles, we must understand these Healthcare Coding Updates as we enter […]
Learn More
pediatric eye care coding

Accurate ICD-10-CM Codes for Pediatric Eye Care

Accurate ICD-10-CM coding for Pediatric Eye Care becomes straightforward when you know what to look for. With Children’s Eye Health and Safety Month as a timely reminder, it’s an excellent opportunity for pediatric providers to review common eye-related diagnoses seen during vision exams. Here, we’ll guide you through three commonly encountered scenarios in pediatric eye […]
Learn More
Surgery global period modifiers

Surgical Global Period Modifiers: Modifier 54, 55, and 56 in Global Surgery Billing

Table of Contents The “Global” Concept Billing the Global Package Modifiers for Split Care Transfer of Care When Not to Use Modifiers 54 and 55 Modifiers: The Key to Accurate Medical Claims Processing To understand these modifiers, it’s essential to first examine the concept of the surgery global period modifiers. All medical procedures with a […]
Learn More
2025 CPT Code Updates

2025 CPT Code Updates: Key Changes in Billing and Coding Practices

Each year, updates to CPT® codes are introduced to reflect advancements in medical procedures and technologies, impacting billing and coding across multiple specialties. Effective January 1, these annual updates encompass new, revised, and deleted codes, along with updated coding guidelines. For 2025 CPT Code Updates, there are 270 new codes, 112 revised codes, and 49 […]
Learn More
Modifier 50

Mastering Modifier 50: Ensure Accurate Billing for Bilateral Procedures

Modifier 50 is used to indicate that a procedure or service was performed on both sides of the body during the same operative session. It’s essential to use this modifier correctly to ensure accurate billing and reimbursement. Key points for appropriate use: Bilateral Procedures: The procedure must be performed on identical, opposing structures (e.g., eyes, […]
Learn More
ICD-10 Coding Challenges

Demystifying the Most Common ICD-10 Coding Challenges

Medical coding is the backbone of administrative and clinical processes in healthcare. This landscape is characterized by the International Classification of Diseases, 10th Edition (ICD-10), which provides a standardized system to classify diseases, injuries, and medical procedures. While ICD-10 offers robust benefits in terms of specificity and data granularity, healthcare professional’s worldwide face significant challenges […]
Learn More
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 […]
Learn More
x