Outsourcing general surgery billing can be a good solution for medical practices looking to streamline their operations and reduce administrative burdens. Outsourcing general surgery billing can provide numerous benefits for medical practices. It can increase revenue, reduce costs, improve efficiency, ensure compliance with regulations, and allow medical practitioners to focus on patient care. Challenges of […]
Outsourcing General Surgery Billing: Need of an Hour
Read More.. Outsourcing General Surgery Billing: Need of an Hour
Billing Guidelines for Bilateral Surgeries
Bilateral Surgeries Billing Bilateral surgeries are procedures performed on both sides of the body during the same operative session or on the same day. Medicare makes the payment for bilateral procedures based on the lesser of the actual charges or 150 percent of the Medicare Physician Fee Schedule (MPFS) amount when the procedure is authorized […]
Surgical Package Coding Guidelines
Most medical and surgical procedures include pre-procedure, intra-procedure, and post-procedure work. When multiple procedures are performed at the same patient encounter, there is often an overlap of the pre-procedure and post-procedure work. Payment methodologies for surgical procedures account for the overlap of the pre-procedure and post-procedure work. The component elements of the pre-procedure and post-procedure […]
Critical Care Service Rule: Update for Surgery Billing
Defining Critical Care Under CY 2022 Medicare physician fee schedule final rule, effective from January 1, 2022, critical care services can be billed as split/shared services. Before discussing the crucial care service rule, let’s define critical care services: the direct delivery by the physician or other QHP of medical care for a critically ill/ injured […]
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 blog, we tried to cover every aspect of billing for surgical assistants including defining surgical assistants, billing guidelines, reimbursement policies, and accurate use […]
Billing Guidelines for Global Surgery Modifiers
The global surgical package, also called global surgery, includes all the necessary services normally furnished by a surgeon before, during, and after a procedure. Medicare payment for a surgical procedure includes the pre-operative, intra-operative, and post-operative services routinely performed by the surgeon or by members of the same group with the same specialty. Physicians in […]
Understanding ‘Separate Procedures’ in Surgery
Defining ‘Separate Procedures’ According to CPT® surgery guidelines, some of the procedures or services listed in the CPT® codebook that are commonly carried out as an integral component of total service or procedure have been identified by the inclusion of the term ‘separate procedure.’ The CPT codes designated as ‘separate procedure’ should not be reported […]
General Medical Billing Frauds in Healthcare Practices
Spending on healthcare in the US is intensive as healthcare spending grew 4.6 percent in 2019, reaching $3.8 trillion or $11,582 per person. As a share of the nation’s Gross Domestic Product, health spending accounted for 17.7 percent. However, an important fraction of this money – up to 10% of total health expenditure is wasted […]
Billing Medicare for Assistant at Surgery
An Assistant at Surgery is a provider who actively assists the physician in charge of a case in performing a surgical procedure. A physician, nurse practitioner, physician assistant, or clinical nurse specialist who is authorized to provide such services under state law can serve as a surgery. Medicare considers advanced registered nurse practitioners (ARNP), physician […]
Basics of Co-Surgeon Billing Guidelines
Under some circumstances, the individual skills of two or more surgeons are required to perform surgery on the same patient during the same operative session. This may be required because of the complex nature of the procedure(s) and/or the patient’s condition. In these cases, the additional physicians are not acting as assistants at the surgery. […]