June 26th 2025
Medicare's new APCM codes empower primary care providers to bill for complex patient management without time constraints, enhancing chronic care delivery.
May 21st 2025
Learn seven proven steps medical practices can use to empower coders, improve coding accuracy, and slash claim denials for a healthier revenue cycle.
January 16th 2025
Company aims to make claims appeals easier and quicker for physicians by having AI do much of the work
January 14th 2025
Behind today's high denial rates lies a fundamental tension – coding requirements grow increasingly complex as coding resources lessen.
January 3rd 2025
Though similar to other specialties, some billing codes are unique for behavioral therapy.
Coding E&M for Preventive Services
This month's coding column looks at whether or not you can count addressing routine chronic conditions without a change in plan of care as E&M.
Five Often-Overlooked Areas of Medical Practice Risk
Physicians are first concerned with treating patients. But they are also business owners. It is a mistake not to review potential areas of risk.
Coding Questions: Collecting Copays from Annual Exams
What are the rules when it comes to completing chart notes after the time of service? Can doctors charge a copay for an annual exam?
As ICD-10 Enters Year Two, Practices Reflect on Transition
It's been one year since ICD-10 has come into effect. How did practices deal with the transition and what's next?
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.
9 Tips for Surviving after the ICD-10 Grace Period Ends
While the ICD-10 grace period was relevant to only CMS, there is still work to be done. Here are nine steps practices can take to ensure post Oct. 1, they are ready.
Understanding Global Billing in a Group Practice
This month's coding questions tackle whether physicians in the same group practice in the same specialty have to bill as a single doctor.
Can an Attending Physician Attest to an NP Consult?
In the world of coding, here's why an attending physician is not really allowed to attest to an NP consult. Also, what are comparative billing reports?
Coding for Distraught Psychiatric Patients
Can you code when a patient is so distraught an appropriate history cannot be obtained, nor can a mental status exam be performed?
Vaccine Coding for Patients 19 and Older
How to institute vaccine administration codes for patients who are older than 19 years of age. Also, guidance on follow-up codes in electronic billing.
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.
An Open Letter to Patients About Medical Billing
Patients can understand so little about their health plan that the billing department is automatically blamed when something goes wrong.
What States Make Patients Pay Out of Pocket the Most?
What state allows for almost 50 percent patient responsibility? Also, which services have the highest percentage of patient responsibility?
Coding for Coordination of Patient Care
Physicians who spend significant time coordinating a patient's care may realize reimbursement in several ways.
Medicare Consult Denials; Coding for Unusual Services
Our coding expert discusses what to do when Medicare denies a consult code; preparation for Medicare chart audits; and coding for unusual services.
The Case to Ignore "Incident to" Billing for PA Services
Here's why you should ignore "Incident to" Billing for PA services, which require a significant amount of additional work without a fair return in revenue.
Coding for Advanced Care Planning
Answers from our coding expert on questions regarding advance care planning; pessary cleaning; and identifying inclusive codes.
Payer-Based Audits are Often a Waste of Time for Docs
While some payer-based investigations into fraud might be based on actual patterns of abuse, most are just an attempt to recoup funds.
How Practices Are Faring with ICD-10 at Six Months
Was the fear and trepidation surrounding ICD-10 overstated or is the early success around a lack of denials only temporary for providers?
One Practice's ICD-10 Experiences at Six Months
Understanding Your Claims Denials
When you look at your cash inflow each month, are you disappointed? That's why it is so important to identify why your claims are being denied.
Improve Compensation by Documenting Prolonged Services
Proper documentation and reporting of codes for prolonged services allows providers to improve compensation for lengthy outpatient services.
Despite Minor Issues ICD-10 Rollout Is Smooth
Since the implementation of the ICD-10 coding system, most claims are processing smoothly and rejection rates have been minimal.
Changes to Incident-To Billing; Time-Based Coding
Answers from our coding expert on questions regarding incident-to billing; time-based coding; and specificity in ICD-10.
Spelling Out Medical Necessity; Duplicative Coding
Answers from our coding expert on questions regarding medical necessity; using the ROS for history of presenting illness; and duplicative coding.
Upcoding vs. Downcoding: Know the Difference
Wrongful Payer Denials: How to Handle Them Quickly
When you are wrongfully denied for a single code or entire claim, do you know what to do?
Modifier 58 vs. Modifier 79; Coding from Fourth-Year Residents
Answers from our coding expert on questions regarding bronchoscopy; modifier 58 vs. modifier 79; and fourth-year residents.
ICD-10 Poll Reveals Few Problems in Transition
Despite all the hoopla surrounding ICD-10, nearly half the practices polled by Physicians Practice had no problems in transitioning to the new code set.