The Role of Code Systems in Healthcare Industry

In today’s rapidly evolving healthcare landscape, efficient management of medical information is vital to provide quality care and ensure accurate reimbursement. Medical coding plays a crucial role in this process, translating complex medical procedures, diagnoses, and treatments into standardized codes. This article explores the significance of code systems in healthcare and highlights the benefits healthcare […]

Clear the Confusion about New Patient CPT Code Range

Defining ‘New Patient’ According to the CPT definition, a new patient has not received professional services from the physician or another physician in the same specialty and group practice within the last three years. Accurate differentiation between new and established patients, alongside the correct usage of the New Patient CPT Code Range, is critical for […]

Tips to Avoid Unbundling Codes

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. […]

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 […]

General Coding Guidelines for ICD-10-CM

ICD-10-CM Basics Selecting accurate diagnosis codes using ICD-10-CM is challenging due to the availability of more than 68,000 codes. In this blog, we shared general coding guidelines for ICD-10-CM, which will help you select accurate diagnosis codes. Before we proceed with coding guidelines, you’ll need access to two lists in ICD-10 CM: the Alphabetical Index […]

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 […]

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Medical Coding