Understanding CPT Code for Pelvic Exam

Pelvic exams are an integral part of women’s healthcare, playing a crucial role in evaluating and monitoring reproductive health. Proper coding and billing for these exams are essential to ensure accurate reimbursement and streamline the billing process. In this comprehensive guide, we will explore into the details of the CPT code for pelvic exam, providing […]

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Know More about ICD-10 CM Codes for Well Women’s Exam

In the world of healthcare coding and billing, accurate documentation and coding play a crucial role in ensuring appropriate reimbursement and effective communication of medical information. When it comes to well women’s exams, understanding the relevant ICD-10-CM codes is essential for healthcare professionals and medical coders. These codes provide a standardized system for classifying and […]

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Clear the Confusion about New Patient CPT Code Range

Defining ‘New Patient’ According to the CPT definition, a new patient is someone who has not received professional services from the physician or another physician in the same specialty and group practice within the last three years, while an established patient has received such services within the last three years. Differentiating between new & established […]

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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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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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Primary Care Physicians Can Earn More with Outsourcing

Primary Care Physicians are Leaving Money on the Table According to a recent study published in the Annals of Internal Medicine, primary care physicians left a large amount of money on the table for services that were provided but not coded and billed. This research estimates that a single primary care physician could add $124,435 […]

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The Struggle of Primary Care Physicians with Dynamic Medical Billing Rules

Medical Billing a Challenge for Struggling Primary Care Practices Medical billing is a complex process and it’s always been a reason for the struggle of primary care physicians. In addition, their practice is often overwhelmed with constantly changing information, including protocols and billing codes which makes the situation more challenging. When the covid-19 pandemic strains […]

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Primary Care Codes for Payment

The technique by which Current Procedural Terminology (CPT) codes are developed with the goal that physicians can get paid for the services and procedures they give is an extremely entangled procedure, one that deserves some explaining. Furthermore, Medical Billers and Coders (MBC) is effectively occupied with this procedure and advocates for the eventual benefits of its clients, […]

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Role of Primary Care Practitioner in DSMT

Diabetes self-management education/training (DSMET) is cost-effective and improves health outcomes as patients maintain better control of their A1C. Diabetes educators provide education/training services and enable physicians to provide comprehensive high-quality care for their patients with diabetes and those at high risk of developing diabetes. The primary care practitioner in DSMT provides general medical care and […]

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Primary Care First (PCF) and Alternative Payment Models

Primary Care First (PCF) Model Options is a set of voluntary five-year payment options that reward value and quality by offering an innovative payment structure to support the delivery of advanced primary care. It will help in prioritizing the doctor-patient relationship; enhancing care for patients with complex chronic needs and high need, seriously ill patients, […]

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