Announcing the Launch of Our Newly Redesigned Website

Announcing the Launch of Our Newly Redesigned Website

At Outsource Strategies International (OSI), we are excited to announce the launch of our newly redesigned website https://www.outsourcestrategies.com/. As a dedicated medical billing and coding company in the U.S, our primary objective with this new design is to ensure that our clients are comfortable and stress-free when interacting with us. We hope that you enjoy a user-friendly browsing experience and easy navigation.

Visually Appealing, Balanced Website Design by MedResponsive

MedResponsive, an experienced website design company and digital marketing agency in the U.S, has done the redesign process.  The company is experienced in providing web design services for all types and sizes of businesses. Their services are focused on developing a strategy that will improve our online positioning and ensure a robust presence. The design team has used the Divi WordPress theme, the most popular WordPress Theme in the world and the ultimate WordPress Page Builder to redesign our website. They also made key changes in text font, size, letter spacing and line height.

The new website better reflects our medical billing and coding services and navigation boxes provide faster access to information on our key services. The Home page provides better access to What we are, Our services, Instagram Feeds, Call to action, Latest Blogs, Divi contact form, and Client testimonials.

This transactional website was built with the intention of empowering our clients with up-to-date information regarding our medical billing and coding services. Medical practices, dental practices, dentists and physicians, hospitals, and other medical entities will find our solutions timely and efficient.

Featuring a modern look, our website was redesigned with users in mind – streamlining menu buttons, easing up navigation, building a fully responsive layout for all platforms, and providing more enhanced content on our services. We expect our website viewers to find the new design useful to find what they’re looking for quickly and efficiently.

BC Advantage Magazine Features OSI’s Articles in March-April 2022 Issue

BC Advantage Magazine Features OSI’s Articles in March-April 2022 Issue

Our medical billing and coding company is glad to announce that our articles “March is National Kidney Month: Know How the Kidneys Support Your Health” by Amber Darst and “Top Strategies to Streamline Prior Authorizations” by Meghann Drella, CPC have been featured in BC Advantage Magazine. The articles appear in the Jan / Feb 2022 | Issue 17.2.

Amber Darst and Meghann Drella are solutions managers at OSI. The article titled “March is National Kidney Month: Know How the Kidneys Support Your Health” by Darst has been published under the Billing and Coding Category. It explains the significance of National Kidney Month and about raising awareness about chronic kidney disease (CKD). The theme of 2022 National Kidney Month is “Get to Know Your Hardworking Kidneys.”

BC Advantage Magazine Features OSI’s Articles in March-April 2022 Issue

Kidney diseases are serious health issues as they may lead to kidney failure and other health problems, such as a stroke or heart attack. According to the National Kidney Foundation, one in three Americans are at risk for kidney disease, and about 37 million, which is more than 1 in 7 U.S. adults, have chronic kidney disease.

Along with highlighting the importance of National Kidney Month, the article also discusses documenting kidney disease and related conditions using ICD-10 codes as well as statistics on kidney disease, signs and symptoms, and the importance of early diagnosis and treatment. The

“Top Strategies to Streamline Prior Authorizations” by Drella has been published under the Practice Management section. The article discusses the importance of prior authorizations and how practices can expedite and improve the efficiency of the prior authorization process. The article also focuses on New Prior Authorization policies which are proposed to take effect January 1, 2023.

BC Advantage Magazine Features OSI’s Articles in March-April 2022 Issue

BC Advantage Magazine is a highly acclaimed, CEU-approved national online healthcare publication and the largest independent resource provider in the industry for medical coders and billers, healthcare auditors, practice managers, compliance officers, and clinical documentation experts. It features articles written by industry professionals on a wide range of subjects such as billing/coding, legal issues, marketing, business building, career advantage, coders 20/20, news, reviews and more.

OSI has been successfully providing accurate medical billing, coding, and insurance verification services to the healthcare industry for well over a decade. The company’s AAPC-certified coders have a strong understanding of ICD-10-CM and CPT requirements and procedures and stay up-to-date with coding changes, payer-specific documentation requirements, and state and federal regulations. The company regularly publishes articles and blogs on medical billing and coding as well as other interesting developments in the field of medicine.

“As a company that has been providing medical billing, coding and other support functions such as insurance verifications and authorizations for medical offices in the USA for more than 15 years, we are proud of our accomplishments. Getting featured on BC Advantage Magazine validates our company’s culture of hard work and customer service,” says Rajeev Rajagopal, President of Managed Outsource Solutions.

OSI provides customized revenue cycle management solutions for all medical specialities. Their experience and expertise have been continuously recognized and featured by BC Advantage Magazine.

For more information about Outsource Strategies International, please visit www.outsourcestrategies.com.

Medicare’s Proposed Changes for Telehealth Services in 2021

Medicare’s Proposed Changes for Telehealth Services in 2021

Our medical billing company stays up-to-date on CMS guidelines and reporting requirements. The proposed 2021 Physician Fee Schedule rule was released by the Centers for Medicare and Medicaid Services (CMS) on August 3. The rule contains several important telehealth policy proposals, which are listed below:

  • Change in definition of direct supervision: CMS proposes to change the definition of direct supervision to allow the supervising physician to meet direct supervision requirements while remote and engage using real-time, interactive audio-video technology (excluding telephone that does not also include video) through Dec. 31, 2021. This change can greatly increase physician leverage and result in new opportunities for incident-to billing.

    Currently, direct supervision requires the physician to be physically present in the office suite and immediately available to provide assistance and direction throughout the performance of the procedure. As this requires the billing clinician to be present on site, it is difficult for the billing clinician to directly supervise services provided via telehealth incident-to their professional services by auxiliary personnel.

    The new definition of direct supervision is based on the belief that services provided incident to the professional services of an eligible distant site clinician could be reported when they meet direct supervision requirements at both the originating and distant site through the virtual presence of the billing practitioner. However, the period for which this change is valid is limited as widespread virtual direct supervision may not be safe for certain clinical situations (www.foley.com).

  • Addition of services to Medicare telehealth services list: The nine new HCPCS codes that CMS is proposing for permanent addition to the Medicare telehealth list include:

    90853 – Group Psychotherapy
    99334, 99335 – Domiciliary, Rest Home, or Custodial Care Services
    99347, 99248 – Home Visits
    GPC1X – Visit Complexity Associated with Certain Office/Outpatient E/Ms
    99XXX – Prolonged Services
    99483 – Cognitive Assessment and Care Planning Services
    96121- Psychological and Neuropsychological Testing

    CMS is proposing to create a temporary category of criteria for adding services to the list of Medicare telehealth services. The services that are meant to be used during the COVID-19 PHE and will remain on the list temporarily are:

    99336, 99337 – Domiciliary, Rest Home, or Custodial Care Services
    99349, 99350 – Home Visits, Established Patient
    99281, 99282, 99283 – Emergency Department Visits
    99315, 99316 – Nursing Facilities Discharge Day Management
    96130, 96131, 96132, 96133 – Psychological and Neuropsychological Testing

  • Additional guidance on community-technology based services (CTBS): CMS defines communication technology-based services (CTBS) as services that can be furnished via telecommunications technology but that are not considered Medicare telehealth services. CMS proposed to allow HCPCS codes G2061-G2063 to be billed by licensed clinical social workers, clinical psychologists, physical therapists, occupational therapists, and speech language pathologists who bill Medicare directly for their services when the service furnished falls within the scope of these practitioners’ benefit categories. CMS is proposing to adopt this policy on a permanent basis. CMS is proposing two additional HCPCS Level II G codes that can be billed by certain nonphysician practitioners who cannot independently bill for E/M services:

    G20X0 – Remote assessment of recorded video and/or images submitted by an established patient (e.g., store and forward), including interpretation with follow-up with the patient within 24 business hours, not originating from a related service provided within the previous 7 days nor leading to a service or procedure within the next 24 hours or soonest available appointment.

    G20X2 – Brief communication technology-based service, e.g. virtual check-in, by a qualified health care professional who cannot report evaluation and management services, provided to an established patient, not originating from a related e/m service provided within the previous 7 days nor leading to a service or procedure within the next 24 hours or soonest available appointment; 5-10 minutes of medical discussion

    To facilitate billing of CTBS by therapists, CMS proposes to designate HCPCS codes G20X0, G20X2, G2061, G2062, and G2063 as “sometimes therapy” services. When billed by a private practice PT, OT, or SLP, the codes would need to include the corresponding GO, GP, or GN therapy modifier to indicate that the CTB are furnished as therapy services furnished under an OT, PT, or SLP plan of care.

Comments on the proposed rule may be submitted to CMS by Oct. 5, 2020.

If implemented, the proposed new changes would expand the use of telehealth technologies among Medicare beneficiaries. Outsourcing medical billing can help clinicians code and bill RPM services correctly in accordance with Medicare requirements.

An Overview of Prostatitis – Symptoms and Medical Codes

An Overview of Prostatitis – Symptoms and Medical Codes

A chronic and painful condition, which is common among men of all age groups, prostatitis refers to swelling and inflammation of the prostate gland. Prostate gland is a walnut-sized gland situated below the bladder and in front of your rectum which produces fluid (semen) that nourishes and transports the sperm. Prostatitis tends to be more common among men under the age of 50. It accounts for nearly 2 million visits per year to outpatient urology practices in the United States. In fact, two to twelve percent of all men experience prostatitis symptoms. Painful or difficulty in urination is one of the most common symptoms associated with the condition. Prostatitis is caused by a number of reasons, which include infection, inflammation or other related causes. However, in some other cases, the exact causes cannot be identified. Depending on the severity of the causes, the infection may occur gradually or suddenly. Urologists and other specialists can rely on medical billing outsourcing companies to report prostatitis diagnosis and screening accurately.

As there are different types of prostatitis, the exact cause of this condition is not known in certain cases. Common bacterial strains are some of the top causes of this condition. The infection can start when bacteria in urine leak into the prostate. Nerve damage in the lower urinary tract which can be caused by surgery or trauma to the area may also contribute to the condition. Antibiotics are normally used to treat the infection. If left untreated, the condition could lead to severe complications like – bacterial infection of the blood (bacteremia), prostatic abscess (pus-filled cavity in the prostate), epididymitis (inflammation of the coiled tube attached to the back of the testicle) and semen abnormalities and infertility issues.

Types of Prostatitis

The National Institute of Health (NIH) classifies prostatitis into four different categories –

  • Acute bacterial prostatitis – This is a sudden bacterial infection caused by the inflammation of the prostate. This is the least common form of prostatitis which typically starts suddenly and may include flu-like symptoms.
  • Chronic bacterial prostatitis – The condition is caused by recurrent urinary tract infections that come from bacteria that chronically infect the prostate gland. Symptoms may include burning with urination, urinary frequency, and pain.
  • Chronic non-bacterial prostatitis/chronic pelvic pain syndrome – This non-bacterial type may depend upon the presence or absence of infection-fighting cells in the urine, semen, and prostatic fluid. Symptoms include pain (genital, abdominal, pelvic), urinary symptoms, and often erectile dysfunction.
  • Asymptomatic prostatitis – Patients with this condition will not experience any specific symptoms or discomfort, but they will have the presence of infection-fighting cells present in semen/prostatic fluid.

Typical Symptoms

People may not experience symptoms suddenly which does not necessitate them to seek immediate emergency medical care. The signs and symptoms of the condition may depend on the causes. Common symptoms include –

  • Pain or burning sensation when urinating (dysuria)
  • Difficulty urinating, such as dribbling or hesitant urination
  • Urgent need to urinate or frequent urination, particularly at night (nocturia)
  • Painful ejaculation
  • Pain or discomfort of the penis or testicles
  • Pain in the area between the scrotum and rectum (perineum)
  • Pain in the abdomen, groin or lower back
  • Flu-like signs and symptoms (with bacterial prostatitis)
  • Cloudy urine
  • Blood in the urine

Diagnosing and Treating Prostatitis

If a physician suspects that a patient has prostatitis or any other related problem, he or she may refer them to an urologist to confirm the diagnosis. Urologists, as an initial step, may conduct a detailed physical examination (like digital rectal exam test) to determine the exact causes and rule other similar conditions that may be causing the symptoms. Physicians will also conduct tests to identify what specific type of prostatitis a patient suffers from. Physicians may evaluate the patient’s medical history and other symptoms as well.

Diagnostic tests like – urine tests (urinalysis to look for signs of infection), blood tests (to look for signs of infection and other prostate problems) and post-prostatic massage (in rare cases) may be performed. In addition, imaging tests like CT scan of your urinary tract and prostate or a sonogram of your prostate may be performed. Depending on the symptoms and the diagnostic test results, the physician will determine which type of prostatitis a patient suffers from.

Treatment for prostatitis depends on the underlying causes and symptoms. Common treatment modalities include – antibiotics, alpha blockers and anti-inflammatory agents (non-steroidal anti-inflammatory drugs (NSAIDs). However, some cases of non-bacterial prostatitis respond to treatments as exercise, myofascial trigger point release physical therapy, progressive relaxation, and counseling. Urologists and other specialists offering specialized treatment to prostatitis patients are reimbursed for their services. The diagnosis, screening tests and other procedures must be carefully documented using the appropriate medical codes. Medical billing and coding services offered by reputable providers can help physicians use the correct codes for their medical billing purposes. For billing and coding purposes, physicians must use the following medical codes –

  • N41 Inflammatory diseases of prostate
  • N41.0 Acute prostatitis
  • N41.1 Chronic prostatitis
  • N41.2 Abscess of prostate
  • N41.3 Prostatocystitis
  • N41.4 Granulomatous prostatitis
  • N41.8 Other inflammatory diseases of prostate
  • N41.9 Inflammatory disease of prostate, unspecified

Prostatitis is often a treatable condition. Patients by clearly following the recommended treatment and medication prescriptions by physicians can manage the condition in the long run. Patients need to follow the full course of the prescription medications, even if they don’t experience any symptoms.

Managing urology medical billing and coding will be much easier for urologists who partner with a medical billing and coding service provider. With a reputable team of AAPC-certified coders and billing professionals to assist them, medical coding and claim submission would be easier and stress free.

Will Moving to a New State affect Medicare Coverage?

Will Moving to a New State affect Medicare Coverage?

Medicare, the federal government program that provides health insurance for U.S. adults (those above 65) and individuals with certain disabilities. Medicare recognizes standard billing codes for many treatments and services. However, with frequent regulatory and coding changes, and stringent claim submission rules, getting paid is much easier with the help of medical billing services provided by experts.

Medicare has four parts: Part A, Part B, Part C, and Part D.
Part A – inpatient/hospital coverage.
Part B – outpatient/medical coverage, including medical equipment
Part C – coverage via a Medicare Advantage Plan that offers out-of-pocket maximums
Part D – prescription drug coverage

Medicare covered about 17.8 percent of the country’s population in 2018, according to Statistica. About one-third of beneficiaries get their Part A and Part B benefits through a Medicare Advantage Plan, which also offers prescription drug coverage and possibly dental and vision care, and other benefits. The remaining two-thirds of enrollees have original Medicare, along with a standalone Part D prescription drug plan and Medigap, a supplemental private health insurance plan, helps fill gaps in normal Medicare plans. Medigap pays for out-of-pocket expenses that Medicare will not cover such as deductibles, co-pays, coinsurance, and health care costs incurred when traveling abroad. Medigap plans also limit what you’ll pay out of pocket each year.

One question people are asking their physician is: can I retain my current Medicare coverage if I move to another state? If you are moving to another state, you should understand rules that apply to Medicare in that state as well as the time that you will get to switch your coverage, if you need to. Generally, making changes may be easy, but in certain cases, more information and work may be needed to make the switch to a new plan.

The first thing to do if you are moving to another state is to contact your insurance provider and make sure your insurance plan is portable and will be accepted by physicians and hospitals in that state. A special enrolment period or guaranteed issue right would be available that can be used to get new coverage in the new state of residence. Here’s what patients need to know about Medicare coverage when they move to another state:

  • Original Medicare: If you are enrolled in Original Medicare, Part A and Part B, will get the same coverage throughout the country. Original Medicare does not have provider networks, and so even if they move to another state, you can use any hospital or doctor that accepts Medicare.
  • Medicare Advantage Plan/Medicare Prescription Drug Plan: Individuals enrolled in a Medicare Advantage plan (Medicare Part C) or Medicare Prescription Drug Plan (Medicare Part D) will need to enrol in a plan that is accepted in the state to which they have moved within two months. This rule would apply even if they are moving to a new address outside their Medicare plan’s service area in the state where they are residing. If the insurance company offers the same Medicare plan in the new service area and the plan is accepting new members, the beneficiary can enrol in the same plan. On the other hand, if the member is moving to an area with limited Advantage Plan, a Medigap plan may be considered.
  • Medigap: Medigap offers 10 standardized policies designated as A, B, C, D, F, G, K, L, M and N. There are also high-deductible versions of Plan F and G in some states. As most Medigap policies are standardized, beneficiaries can remain in the same plan even if they move to another state, though the premiums may vary depending on the area or more precisely, its zip code. Here are the lowest and highest costs Medicare plan G 2020 provided by the American Association for Medicare Supplement Insurance:
    • Lowest cost for a woman age 65 – $91.78 per-month in Chicago (Zip Code 60601).
    • Lowest cost for a man turning 65 – $103.68 per-month in Chicago.
    • Highest cost for a woman turning 65 -$476.04 per month in New York (Zip Code 10012).
    • Highest cost for a man turning 65 – $509.10 in Philadelphia (Zip Code 19050).

If you have a Medigap policy and are moving to another state, your insurer can tell you what the policy will cost in your new state of residence from your zip code. If you find that the cost is higher, you can look for a cheaper policy but it would involve medical underwriting, which can be very expensive.

Part D prescription drug plan: Like Medicare Advantage, Part D prescription drug plan availability differs from state to state. Individuals moving out from one service area to another have two months before and after they move to choose new Part D coverage. If the switch is not made within this period, there would be a penalty to pay for each full month for which the person did not have coverage.

Medicare Select: Available in some places, Medicare Select plans are a type of Medigap plan that may have a lower premium than a regular Medigap plan that provides the same benefits. Insurance companies offer Medicare Select plans based on the network agreements they have with medical providers in a given area. This means it will no longer be valid if the beneficiary is moving out of state. Beneficiaries who had been enrolled in the Select plan for at least 6 months can enrol in a regular Medigap plan from their existing insurer. which may have more or fewer benefits than their Select policy. They can also choose from Medigap Plans A, B, C, F, K, or L, regardless of when they were enrolled in Medicare Select. Those who qualified for Medicare on or after January 1, 2020 cannot enrol in Plan C or F, but can opt for either Plan D or G (www.medicareresources.org).

For physicians, billing Medicare and Medicaid is an important but complicated task, especially with new codes and new rules. Outsourcing medical billing and coding is the best way to handle this challenge.

Our Top 10 Most Popular & Enlightening Blog Posts of the Year 2019

Our Top 10 Most Popular & Enlightening Blog Posts of the Year 2019

Our blog posts have enlightened and educated readers on countless aspects of medical billing and coding as well as insurance eligibility verification, while providing detailed instructions on various ICD-10 and CPT codes. We have also shed insight on new insurance policies, and given doctors and other healthcare professionals a helping hand in understanding the procedural aspects of insurance and billing so they can focus on their core task of treating patients.

Before we embark on a New Year and a new decade, here’s look back at our top 10 blog posts of 2019:

• Coding Colectomy – Key Considerations for Claim Submission

Colectomy is a complex procedure involving a range of individual procedure codes. We break down the different surgical procedures involved and various conditions that require colectomy to be performed. Finally, we list in detail the different codes you need to consider and also the right approach to coding.

• Fine Needle Aspiration Biopsy – 2019 CPT Code Updates

We have covered medical codes for innovative and subtle procedures as well, such as Fine Needle Aspiration (FNA) biopsy. With FNA codes having been updated recently, we thought it appropriate to post an infographic to make matters clearer to our readers.

CPT Codes for Epidural Injection Procedures and Diagnostic Selective Nerve Root Blocks

This blog talks about navigating code and guideline revisions for procedures such as epidural injections as well as nerve root blocks. Apart from applying the appropriate CPT codes, pain management physicians also need to document the necessity of performing these services in order to avoid claim denials.

• Medical Coding Steps and Guidelines for Lesion Excision

You can read about coding for biopsy excision and also important aspects of documentation such as mentioning whether a lesion is malignant or benign, where the lesion is located, and also the diameter of the excised lesion.

Billing and Coding for Arthroscopic Knee Surgery

We’ve dealt with the complex aspect of knee surgery in this blog on arthroscopic knee surgery. Coding knee surgery is complex because of the fact that modifier usage, payer guidelines and varying definitions need to be understood better. We simplify all that for you.

CPT Code Changes for 2020 – Highlights & Implications

The American Medical Association (AMA) has updated the CPT code set for 2020. Come to think of it, there are 394 code changes. Only 248 of them are new codes. The rest are code deletions and revisions. Correct reimbursement and coding require you to figure out these changes. It can be overwhelming but we’ve explained the highlights and their implications in this blog.

Influenza Vaccine Recommendations and CPT Codes for the 2019-2020 Season

The flu season made it appropriate for us to write about the CPT codes on the influenza vaccine. The annual flu vaccine is recommended by the Centers for Disease Control and Prevention (CDC) for protecting against flu. We have highlighted the various CPT codes for administering the flu vaccine.

Steps Involved in Billing for Orthodontic Services

As dental insurance reimbursement rates keep changing along with the rules and regulations, dental billing keeps getting complex. Since orthodontic treatment sometimes extends for multiple plan years, reimbursement requires efficient billing. We detail the procedures involved along with special guidelines.

Updates for Anesthesia Coding and Reporting Guidelines in 2019

Anesthesia billing and coding has to be done with minute attention to detail to ensure accuracy of the codes used. Any errors can cause anesthesia groups to be the target of fraud detection efforts of the government. January 1, 2019 saw the introduction of many updates and changes and we have strived to clear the confusion and provide details regarding those updates.

Document and Code for Hypertension Using ICD-10 Codes

Hypertension (HTN) is a condition affecting a large number of Americans. Also called high blood pressure (HBP), the condition affects nearly half of American adults. That means there is a greater possibility of people visiting your practice with this condition. So, a guide on ICD-10 documentation for hypertension can prove to be useful.

Feel free to check out our blog section to get more insight into billing and coding for a range of medical conditions as well as other aspects such as documentation and insurance eligibility verification.