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Medical Billing Services
Billing Guidelines for Chronic Care Management (CCM)
Chronic Care Management (CCM) services are generally non-face-to-face services provided to Medicare beneficiaries who have multiple (two or more) chronic conditions expected to last at least 12 months, or until the death of the patient. The Centers for Medicare & Medicaid Services (CMS) recognizes that CCM is a critical component…
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Medical Billing Services
Original Medicare Coverage and Payment Related to COVID-19
Diagnostic Tests Medicare Part B, which includes a variety of outpatient services, covers medically necessary clinical diagnostic laboratory tests when a doctor or other practitioner orders them. Medically necessary clinical diagnostic laboratory tests are generally not subject to coinsurance or deductible. Medicare Part B also covers medically necessary imaging tests,…
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Ambulatory Surgical Centers
Understanding ASC Coding and Billing
Beginning January 1, 2008, the CMS publishes updates to the list of procedures for which an ASC may be paid each year. In addition, CMS publishes quarterly updates to the lists of covered surgical procedures and covered ancillary services to establish payment indicators and payment rates for newly created Level…
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Medical Billing Services
2020 Medical Coding Update for Telehealth
There are three options for telehealth and other communications-based technology services i.e. Telephone calls, Internet consultations, and Telemedicine exams. This information is based on guidelines from the Centers for Medicare & Medicaid Services. 1. Telephone Calls HCPCS code G2012 Description: Brief communication technology-based service, e.g. virtual check-in, by a physician…
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Medical Billing Services
Medicare Advantage Plan Coverage and Payment Related to COVID-19
Medicare Advantage plan (also known as “Part C”) is an “all in one” alternative to Original Medicare. Medicare Advantage plans cover Medicare Part A and Part B services, and usually prescription drugs covered under Medicare Part D. These plans also may offer extra benefits Original Medicare doesn’t cover. Medicare Part…
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Ambulatory Surgical Centers
Correct Use of Modifier 50 in ASC Billing
Modifiers are two-digit symbols added to CPT procedure codes to signify the procedure has been altered in some way. Modifiers are accepted by Medicare and most other payers, however, using modifiers correctly can be confusing, since not all payers want modifiers used the same way. Not using Modifiers according to…
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Medical Billing Services
Are you correctly Using 99291 and 99292 codes?
Critical care is the direct delivery by a physician(s) of medical care for a critically ill or injured patient. The care of such patients involves decision making of high complexity to assess, manipulate, and support central nervous system failure, circulatory failure, shock-like conditions, renal, hepatic, metabolic, or respiratory failure, postoperative…
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