Billing Compliance

It seems the traditional understanding of modifier 59 has changed. Here's information for your medical practice.

The feds are cracking down on (even accidental) violations of data security rules. Here's how to avoid serious financial and administrative penalties.

It used to be that you examined the patient. But from your credentials to your use of technology, patients are increasingly examining you. Here's how to deal with this new generation of engaged, informed, and demanding patients.

Looking for the proper way to use modifier -25 at your medical practice? Here is some expert medical coding advice.

Coding questions? We've got the answers

To stay safe and weed out the billing and collections problems stifling your practice's revenue stream, our experts recommend a "bottom-to-top" assessment of your entire billing operation.

Coding questions? We've got the answers

You may be afraid of audits, but if you aren't auditing your own billing procedures, you're probably losing a fortune. Here's how.

The Office of Inspector General included "identical notes" as an area of interest in its 2011 Work Plan. Make sure your patient notes reflect each unique encounter.

Changes with ICD-9 and CPT codes have been commonplace for several years and will almost assuredly continue, even with the adoption of ICD-10 in 2013. We must adapt to the change by updating our practice management systems to include the changes to ICD-9, CPT, and new rules by CMS and insurance payers.

You might feel more justified than most in taking out your frustration on others, but be careful - the emotional hangovers you might create can often have a long-lasting effect on your practice.

Coding questions? We've got the answers.

Once you know your practice is being evaluated by payers, monitor yourself using the same metrics to stay on top of your game.

The "mHealth" industry has exploded, and smartphones, tablets, and apps are the buzzwords du jour. Trying to figure out how mobile devices and mHealth solutions can work for your practice can be overwhelming, but it’s crucial to stay current. We tell you how to get plugged in.

Opting for an in-house pharmacy or office dispensing can enable your practice to maintain higher profit margins, but before you jump onboard examine all the costs first.

Here's some medical coding guidance on CERT reviews; a new CPT modifier; Medicare visit reviews; and more.

The Affordable Care Act added a new Medicare Annual Wellness Visit. Contrary to patient and physician expectations, it is not a physical exam.

This physician wants to know if he can bill for infusion services in an outpatient setting.

How to code for dental pre-op exams?

This doc wants to know how to bill inpatient services using the primary-care exception rule.

Clinicians should make sure they clearly document the patient's level of risk when comorbid conditions are present.

This physician wonders how to get around documenting the "I saw and examined" clause in every patient record.

Does prescribing a new medication qualify as a moderate level decision making?

Can this doc bill for both health maintenance and a problem-based visit on the same day, if counseling is involved?