Enhancing Legacy AR in General Surgery Practices

The efficient handling of legacy accounts receivable (AR) in general surgery operations is a chronic challenge for general surgery practices, affecting revenue and operational success. This article explores modernizing AR procedures by incorporating industrial practices and scientific research, acknowledging the need for improvement. General surgery clinics face issues due to inefficient operations and lost income […]

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Strategies for Maximizing Billing with CPT Codes in General Surgery

CPT codes in general surgery and employing effective billing strategies are crucial for healthcare providers to ensure fair and accurate reimbursement. Navigating the world of medical billing and coding in general surgery can be akin to solving a complex puzzle. Understanding the nuances, let’s dive into this blog to demystify CPT codes in general surgery […]

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Outsourcing General Surgery Billing: Need of an Hour

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 […]

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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 […]

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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 […]

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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 […]

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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 blog, we tried to cover every aspect of billing for surgical assistants including defining surgical assistants, billing guidelines, reimbursement policies, and accurate use […]

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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 […]

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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 […]

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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 […]

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