What is Unbundling Codes? Unbundling codes in medical billing refers to the practice of separately billing for individual components of a medical procedure or service, rather than billing for the complete procedure or service as a single entity. This practice can result in higher payments to healthcare providers and higher costs for patients and insurers. […]
Tips to Avoid Unbundling Codes
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Key Strategies for Improving Medical Coding Accuracy
Medical coding is a key process of revenue cycle management. Whether you are facing a high rate of denials and not achieving best-in-class A/R outcomes or not receiving timely insurance reimbursements, the impact of low-quality coding shows very quickly on your practice collections. Medical coding not only produces clean claims but also helps identify issues […]
Stay Coding Compliant with Medical Audits
Basics of Coding Compliant with Medical Audits A coding audit is a review of a medical office’s coding practices conducted by reviewing patient medical records. Medical record audits target and evaluates procedural and diagnosis code selection as determined by physician documentation for completeness and accuracy. Medical audits cover: assessing the proper use of CPT codes; […]
Improving Medical Coding Quality
Even though medical coding plays a crucial part in revenue cycle management, it is the most neglected process of medical billing. As per the study report, documentation and medical coding are considered to be the weakest processes of the revenue cycle in 2019. Accurate medical coding will ensure the claims will get out the door […]
Diagnosis Coding Guidelines for Aftercare
Aftercare visit codes cover situations when the initial treatment of a disease has been performed and the patient requires continued care during the healing or recovery phase, or for the long-term consequences of the disease. Post-op care is different from aftercare. Post-op care falls into this category of care when the condition that precipitated the […]
CPT Codes for Third Doses of COVID-19 Vaccine
The American Medical Association (AMA) on 16th August 2021 announced that the Current Procedural Terminology (CPT®) code set is ready for the rollout of third doses of the Pfizer and Moderna COVID-19 vaccines. The CPT Editorial Panel has expedited approval of a new administration code that is unique to a third dose of the current […]
Coding Guidelines for Interprofessional Internet Consultations
Interprofessional Internet/Telephone/EHR Consultations Interprofessional Telephone/Internet/EHR Consultations (99446-99449, 99451, 99452) are assessment and management services in which a patient’s treating (e.g., attending or primary) physician or other QHP requests the opinion and/or treatment advice of a physician with specific specialty expertise (the consultant) to assist the treating physician or other QHP in the diagnosis and/or management […]
Guidelines for E/M Coding 2021
In order to reduce the administrative burden of coding guidelines, the American Medical Association (AMA) Current Procedural Terminology (CPT) Editorial Board and the U.S. Centers for Medicare & Medicaid Services (CMS) have proposed simplifications of the official evaluation and management (E/M) coding system to begin January 2021. The Guidelines for E/M Coding define the requirements […]
Newly Added CPT Codes for COVID-19 Vaccines
Working closely with the Centers for Disease Control and Prevention, the AMA CPT Editorial Panel approved unique CPT Codes for COVID-19 vaccines as well as administration. The new CPT codes clinically distinguish each coronavirus vaccine for better tracking, reporting, and analysis that supports data-driven planning and allocation. Newly added CPT codes and their descriptors are […]
What you should know about Denial Code CO 50?
Denial Code CO 50 means that the payer refused to pay the claim because they did not deem the service or procedure as medically necessary. It is a very popular denial code and the sixth most frequent reason for Medicare claim denials. According to a CMS, It is observed that 30% of claims are either […]