Top 5 Medical Billing Challenges Faced by Providers post Pandemic

After COVID-19, providers are now ready to provide excellent patient care through direct and virtual modes. Medical billing has always offered unique medical billing challenges prior and post-pandemic. Due to the changed billing environment post-pandemic, this struggle to receive accurate reimbursement has become more real than ever. As a leading medical billing company, Medical Billers […]

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Are You Aware of These Coding Guidelines for Urology Supplies?

In this article, we shared coding guidelines for urology supplies updated for the year 2022. To share these guidelines, we referred CMS document on Local Coverage Determination (LCD) for urological supplies and Medicare Advantage Policy Guidelines for urological supplies from United Healthcare. Consider below mentioned guidelines as general guidelines for urology supplies. For payer-specific reimbursement […]

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Improving Coding for Hypertension Associated with Diabetes

Basics of Coding for Hypertension Associated with Diabetes Most coders are still confused about which is the correct code for hypertension associated with diabetes. If you look carefully, hypertension is not listed as a specified complication. Hypertension is considered a circulatory complication so the correct code could be E11.59 rather than the more unspecified code […]

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Improve Ophthalmology Collections In Spite of Medicare Payment Cuts

Proposed Medicare Payment Cuts Centers for Medicare and Medicaid Services (CMS) proposed 2022 Medicare Physician Fee Schedule and Quality Payment Program rules and included a 3.75 percent reduction in the conversion factor used to calculate payments to physicians. The cuts are the result of a reduction that is necessary to keep Medicare payments budget neutral. […]

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Medicare Diabetes Screening Billing Guidelines

Medicare Diabetes Screening Billing Medicare Part B covers patients with certain diabetes risk factors or diagnosed with pre-diabetes. But note that patients previously diagnosed with diabetes aren’t eligible for diabetes screening benefits. Medicare covers 1 screening every 6 months for patients diagnosed with pre-diabetes and 1 screening every 12 months if previously tested but not […]

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HIPAA Compliant Ophthalmology Medical Billing Services

Basics of HIPAA Medical Billers and Coders (MBC) being a leading medical billing company manages all revenue cycle management activities in HIPAA compliant way. In this article, we shared the basics of HIPAA compliance, and how selecting HIPAA-compliant ophthalmology medical billing services can help to receive accurate insurance reimbursements while reducing the chances of payer […]

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Preventive Medicine Services Coding Guidelines

Basics of Preventive Care Preventive care helps detect or prevent serious diseases and medical problems before they can become major. Annual check-ups, immunizations, and flu shots, as well as certain tests and screenings, are a few examples of preventive care. This may also be called routine care. While coding, you need to understand the difference […]

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Selecting E&M Based on Time

Prior to 2021, the time associated with CPT codes 99202-99215 was based specifically on the typical face-to-face time the physician/qualified health care professional (QHP) spent on the day of the encounter. After 2021, providers may select the level of office and outpatient evaluation and management (E&M) services based on either time or medical decision-making. In […]

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Billing for Surgical Assistants: What you should know?

Surgical Assistants Practices lose insurance reimbursement by incorrectly billing surgical assistants. In such cases, the major reason for claim denials is to use the wrong modifier/ not use the modifier. In this article, we tried to cover every aspect of billing for surgical assistants including defining surgical assistants, billing guidelines, reimbursement policies, and accurate use of […]

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Medicare SNF Billing Coverage 2022

Medicare Part A covers skilled nursing and rehabilitation care in a Skilled Nursing Facility (SNF) under certain conditions for a limited time. Coverage for care in SNFs is measured in ‘benefit periods’ or sometimes ‘spell of illness’. In each benefit period, Medicare Part A covers up to 20 days in full. After that, Medicare Part […]

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