Healthcare providers implemented telehealth for COVID-19 pandemic widely in the US. According to 2019 Health Center Program Data, 43% of health centers were capable of providing telemedicine (it is a part of telehealth), compared with 95% of the health centers that reported using telehealth during the COVID-19 pandemic. While the largest increase in the use […]
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 […]
Today various private and public ambulance transport services are operating in a huge number for servicing critical patients at crucial moments. These players are getting reimbursed under Medicare Part B which covers ambulance transport medical billing with certain limitations. Let’s understand Medicare Part B in more detail: Medicare Part B Medicare Part B covers emergency […]
NSTEMI, Type 1 vs Type 2 MI: Why Accurate ICD-10 Coding Directly Impacts Revenue and Compliance Myocardial infarction (MI) documentation errors are no longer just clinical inaccuracies. In today’s reimbursement environment, misclassifying Type 1 MI, Type 2 MI, demand ischemia, or assigning incorrect NSTEMI ICD-10 codes — including Non-ST Elevation (NSTEMI) ICD-10 codes — can […]
Today physicians whether they own their practice or are employed by a hospital or larger health system are facing many challenges in the day-to-day routine. These common challenges include “How to use the EMR efficiently and getting paid”, overburden with administrative requirements, staffing, burnout, etc. despite their devotion to the practice of medicine and the […]
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 […]
If your Medicaid crossover claims are rejecting it may be due to the address you have on file with Medicare and Medicaid. When Medicare crosses over your claim to Medicaid, address fields like Master address and Pay-to (or remit address) are submitted. If Medicaid does not have the same addresses in their file, Medicaid will […]
CMS recently announced the proposed rules for the ‘Inpatient Psychiatric Facility Prospective Payment System and Inpatient Rehabilitation Facility Prospective Payment System’ for FY 2022. This proposed rule would update the prospective payment rates for IRFs for Federal FY 2022. The proposed FY 2022 IRF Prospective Payment System rule would boost Medicare payments by 1.8%, or […]
In the US, providers are struggling daily basis with healthcare frauds. These frauds generally cost the healthcare industry 3 to 15 percent of the total expenditure in the United States hence healthcare fraud and abuse must be critical. What are healthcare fraud and abuse? Generally, fraud and abuse are referred to describe a range of […]
The physician or other qualified healthcare professional are using CPT codes from the range 99202-99499 which is called Evaluation and management (E/M) codes to represent services offered by physicians. These codes are applicable while evaluating and managing patient health. These (E/M) codes have been around for many years still reporting timed-based services is confusing. So let’s […]
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