Many changes have affected primary care physicians (PCPs) in recent times. These include the shift to value-based care from the fee-for-service payment model, new regulatory requirements, the rise of new models of care, and the merging of independent practices with...
New Epidural Injection Codes to Improve Pain Management Reimbursement in 2017
Starting January 1, 2017, there are eight new epidural injection CPT codes which replace codes 62310-62311 and 62318-62319. When it comes to pain management billing, knowledge of the new codes and CPT instructions is crucial for compliance and appropriate and timely...
Maximize Reimbursement for Care Coordination Services
Though physicians spend a lot of time counseling patients, they usually tend to overlook the reimbursement opportunity for this service. According to CPT guidelines, medical billing and coding for evaluation and management (E&M) services revolves around 7...
Avoid the Perils of Undercoding with Medical Billing Services
Undercoding is as much a problem as overcoding and occurs when the CPT and HCPCS codes billed do not indicate the full scope of the work performed by the physician or facility. In addition to lost revenue, undercoding is likely to make you a target for audits....
Proactive Strategies to Optimize Medical Coding and Billing in 2017
As you wrap up an eventful 2016, you need to prepare your medical practice for the changes in store for 2017. For one, there will be 75,625 ICD-10-PCS codes for the fiscal year (FY) 2017, of which 3,651 are new codes and 487 are revised. There are also many CPT coding...
Medicare’s New Health Insurance Market Place Rules – Impact on Risk Adjustment/HCC Coding
The Centers for Medicare and Medicare (CMS) has released new health insurance market place rules which will take effect from January 17, 2017. Referred to as the “payment notice,” the rule is an annual CMS omnibus rule that covers all the major changes that CMS plans...
Exclusion of CRNAs from New VA Policy could Impact Anesthesia Medical Billing
Anesthesia reimbursement comes with unique challenges, as experienced medical billing and coding companies know. A recent Department of Veteran Affairs (VA) ruling puts the spotlight on the providers of anesthesia services and can also affect CRNA medical billing....
Anesthesiology ICD-10 Documentation Tips
Success in physician billing services under ICD-10 depends on proper clinical documentation and this is critical for anesthesiology. In addition to obtaining higher reimbursement, changing healthcare payment models also make it necessary for anesthesiologists to...
Dental Billing Fraud and Abuse – Know the Facts
Dental practices are under increasing scrutiny by Medicare, commercial insurance companies and regulatory bodies after recent reports of dental billing fraud and abuse. While partnering with a dental billing company can help maintain practice integrity and compliance,...
Many Patients may be Underinsured – Medical Eligibility Verification is Crucial
The Affordable Care Act (ACA) improved Americans’ access to healthcare, but a recent report in the New York Times highlights the fact that many people may be still underinsured. This makes medical eligibility verification all the more important for healthcare...