Tag: Modifiers

Medical coding and billing challenges

Overcoming Medical Coding & Billing Challenges | Allzone

Medical coding and billing are critical components of the healthcare revenue cycle. They ensure that healthcare providers receive proper reimbursement for the services rendered. However, the ever-evolving regulatory landscape, shifting payer policies, and technological advancements present numerous Medical Coding & Billing Challenges. These challenges significantly impact the efficiency and accuracy of the revenue cycle. As […]
Learn More
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 […]
Learn More
Boost Revenue By Getting Coding Right

Boost Revenue By Getting Coding Right

It’s every physician’s worst nightmare: Receive payment for services rendered, but then a payer identifies an aberrant pattern in claims data, audits the records, decides it has overpaid the practice, and recoups those funds. That money you already allocated for overhead, staff salaries, bonuses, or new medical equipment? Gone. With one post-payment audit, you now […]
Learn More
Top 13 Reasons For Claim Denials

Top 13 Reasons For Claim Denials

Denied claims are one of physicians’ chief complaints when it comes to dealing with payers. To a certain extent, every practice deals with claim denials. It’s those practices that eliminate the most common reasons that experience a smoother revenue cycle and find greater financial success. Here are the 13 most common reasons for why claims […]
Learn More
Coding “Separate Procedures”

Coding “Separate Procedures:” What Coders Need to Know

“Separate procedure” may not mean what you think. Many procedural codes in the CPT® Book are designated as “separate procedures.” However, the common misinterpretation of this is that coders can report such codes as such in every case. Not true. First, you must consider: Were there other procedures performed during the same encounter? Did you consult […]
Learn More
Functional Limitation Codes

CMS Eliminates Reporting of Functional Limitation Codes

CMS also has updated its therapy manuals, making elimination of FLR official. Many therapy providers, at hospital outpatient departments and private-practice clinics alike, were reluctant to stop submitting functional limitation reporting codes and impairment modifiers until they could see the guidance clearly written in black and white in the associated therapy policy manuals. While the […]
Learn More
x