Pain management practices face several unique medical billing challenges. Accurate billing and coding is essential for proper reimbursement and compliance, but can be challenging due to the complexity and specificity of the treatments. Outsourcing pain management...
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Strategies to Overturn and Prevent Medical Necessity Denials
Hospitals and other healthcare organizations are under continuous financial stress and various operational challenges in the post COVID-19 era. Among them, medical necessity denials is a persistent...
Why and How to Use ICD-10 External Causes Codes
ICD-10 External Cause Codes (V00-Y99) are secondary codes that capture specific details about an injury or health event. Though it is not mandatory to use external cause codes, medical coding...
Reporting Tuberculosis Diagnosis and Testing
According to the World Health Organization (WHO), tuberculosis (TB) is second biggest infectious killer of adults worldwide. In the US, more robust control programs have reduced the number of TB...
Appropriate Use of Modifiers 25 and 59 in Chiropractic Medical Billing
According to recent reports, chiropractic practices received denials from Blue Cross and Blue Shield (BCBS) for claims billed with modifiers. Medical billing outsourcing companies that provide...
Orthopedic Medical Coding Ideas for Closed Treatment of Fractures without Manipulation
Of the different fracture treatment methods such as closed reduction and percutaneous fixation an orthopedic physician provides, closed treatment without manipulation involves fitting the patient to...
OIG Reports Compliance Issues in Claims for Outpatient Physical Therapy Services
According to a March 2018 report from the Office of Inspector General (OIG), many Medicare claims for outpatient physical therapy (PT) services did not comply with Medicare requirements. The study’s...
How To Report Systemic Lupus Erythematosus with the Correct ICD-10 Codes
Systemic lupus erythematosus (SLE) or lupus is an autoimmune disease in which a person's immune system is overactive and attacks various organs or cells of the body, causing severe damage and...
Patellar Tendonitis Documentation with Accurate ICD-10 Codes
Those interested in sports will be quite familiar with the term "Patellar tendonitis". Also referred to as "jumper's knee", it is a knee injury affecting the patella tendon. It is common in...
Diagnosing and Documenting Pneumonitis – An Overview
Pneumonitis is a general term that refers to inflammation of lung tissue. Also referred to as hypersensitivity pneumonitis, this disorder is caused when a person has an allergic reaction in their...
Reporting Chronic Conditions in the Age of Value-based Reimbursement
The shift from fee-for-service to fee-for-value has changed the way physicians provide care, bill for services, and get reimbursed. As three out of four Americans are living with multiple chronic...