Most read 2022: The basics of incident-to billing
Here are six basic requirements to meet incident-to guidelines and get properly reimbursed for your care.
The Basics of Incident-To Billing
How to Choose Between Modifiers 25 and 57
When do you use modifier 25 or 57? Coding expert John Verhovshek explains the difference when coding an E&M service.
Meeting Medicare Requirements to Report Telehealth Services
Using telehealth services? Here are the basics on reporting this to Medicare, in order to get properly paid.
Transitional Care Management: Coding and Documentation in Brief
Everything you want to know about coding a transitional care management encounter, including what services are included.
Coding for Moderate Sedation is Different in 2017
Revised codes and coding guidelines for 2017 completely change reporting for moderate sedation services. Here's what you have to know.
Correct Coding for Vaccine Administration
CPT designates six codes to report vaccine administration. Here's how to make sure you are reporting the correct service and conditions.
Coding Requirements for Transitional Care Management
Coding for TCM services should include global periods; dates of service; and correct documentation.
Making the Most of Transitional Care Management
TCM helps patients transition from the hospital to the community. Many physicians, however, miss deserved reimbursement because they lack documentation.
Coding for Coordination of Patient Care
Physicians who spend significant time coordinating a patient's care may realize reimbursement in several ways.
Improve Compensation by Documenting Prolonged Services
Proper documentation and reporting of codes for prolonged services allows providers to improve compensation for lengthy outpatient services.
Upcoding vs. Downcoding: Know the Difference
How to Apply Modifier 58
Physicians should use modifier 58 to indicate a staged or related procedure that was planned in advance.
Chronic Care Management: Coding and Billing Criteria
Physicians spend significant time managing patients with chronic diseases. Now, under certain conditions, they can be paid for their time.
Use Modifier 78 When Treating Complications in the OR
When billing for an unplanned return to the OR that is related to the original procedure, use modifier 78.
Applying Modifier 52 and Modifier 53
When choosing between modifier 52 and modifier 53, ask yourself, "Why did the provider not complete the procedure or service?"
Same-Day Patient Visit and Procedure Can Be Reimbursed
Insurers typically do not reimburse an E&M service and procedure performed on the same date of service. But, careful documentation can change that.
Low Hanging Fruit: 4 Easy-to-Avoid Coding Mistakes
Medical coding is a challenge, but a dose of caution will help you to avoid many of the most common coding errors. Here are four areas to watch.
Coding Pneumococcal Vaccination for Medicare Beneficiaries
Coverage and reporting requirements for pneumococcal vaccine in Medicare beneficiaries has recently changed. Here's what you need to know.
When a Preventive Visit Uncovers a New Patient Complaint
It's possible to be reimbursed for a preventive visit and a problem-focused visit performed on the same day, but proper documentation and coding is critical.
'Mix and Match' Documentation for Higher Reimbursement
Physicians may find that revised coding guidelines allow their coding and billing to better reflect the documented level of service provided.
A Medical Practice's Guide to Incident-To Billing
The incident-to rules can be confusing for many physicians, practice managers, and billers and coders. Here's some helpful guidance.
Documenting Uncertain Diagnoses: Tips for Physicians
In the outpatient setting, physicians should never assign a diagnosis unless that diagnosis has been confirmed by diagnostic testing, or is otherwise certain.
Medicare Moves to Replace Modifier 59
Not only should your practice prepare to use new modifiers by Jan. 1, you might also experience even greater scrutiny of future modifier 59 claims.
CMS Proposal Eliminates Global Periods, Could Boost Primary Care Demand
If a CMS proposal goes into effect, primary-care providers are likely to be called on more often to provide follow-up care (primarily, evaluation and management services).
The Top 4 Tips to Code Medical Time-based Services Appropriately
Except where CPT guidelines state otherwise, follow these four tips to ensure you’re reporting time-based services correctly.
How to Code, Negotiate After-Hours Reimbursement at Your Practice
Here's why you should seek - and more importantly, how to code - reimbursement for after-hours services at your medical practice.
