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Medical Billing Services
Using Correct Combinations – Modifier 59
One of the most frequent errors can result from using the wrong modifiers. In addition to the accurate coding of treatment, medical claims must be billed in combination with codes for additional services performed in the office, the corresponding modifiers, if necessary, and ICD-10 or diagnosis codes. In this article,…
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General Surgery Billing Services
Using Correct Combinations – Modifier 24 and 25
One of the most frequent errors can result from the submission of invalid modifier combinations. In addition to the accurate coding of treatment, medical claims must be billed in combination with codes for additional services performed in the office, the corresponding modifiers, if necessary, and ICD-10 or diagnosis codes. The…
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Medical Billing Services
Provisional Prior Authorization from Medicaid- Three State Approach
Beneficiaries who are dually eligible for Medicare and Medicaid often experience difficulties accessing durable medical equipment (DME), such as wheelchairs, in a timely manner. Whether Medicare or Medicaid covers a specific item may be unclear. Medicaid usually is the “payer of last resort,” which means that DME suppliers generally must…
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Medical Billing Services
Using Correct Combinations – Modifier 50
One of the most frequent errors can result from the submission of invalid modifier combinations. In addition to the accurate coding of treatment, medical claims must be billed in combination with codes for additional services performed in the office, the corresponding modifiers, if necessary, and ICD-10 or diagnosis codes. In…
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Medical Billing Services
Reimbursement Guidelines for Modifier 90
Reference (Outside) Laboratory: When laboratory procedures are performed by a party other than the treating or reporting physician, the procedure may be identified by adding the modifier 90 to the usual procedure number. For the Medicare program, this modifier is used by independent clinical laboratories when referring tests to a…
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Podiatry Billing Services
CMS Proposes HCPCS G-codes for Podiatric E/M Visit Payment Scheme
In July 2018, CMS has proposed a major reworking of its evaluation and management (E/M) visit payment scheme to reflect more accurately the resources used in different types of care. They have proposed to create two HCPCS G-codes, HCPCS codes GPD0X (Podiatry services, medical examination, and evaluation with initiation of…
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Podiatry Billing Services
Correct Use of Modifiers for Podiatry Services
Improper use of modifiers can be the cause of claim denials just as not using a modifier can be. When using modifiers, make sure you clearly understand what the modifier entails. Sometimes, there are related services that the physician is performing, global periods to contend with, etc. Modifiers will clarify…
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