Moderate (Conscious) Sedation Coding Guidelines

Moderate Sedation Coding Guidelines To ensure accurate billing, it’s essential to follow Sedation Coding Guidelines, which specify the proper codes for different sedation levels and procedures. By adhering to these challenges, medical practices can avoid coding errors and ensure appropriate reimbursement. Moderate sedation is a service provided by the physician or other qualified healthcare professional […]

Key Points for Assistant-at-Surgery Billing

Assistant surgeon billing can seem overwhelming, so it’s crucial to take it one step at a time. But there are several key points to remember that will make it much easier to understand. Assistant at Surgery: An assistant at surgery is a physician or non-physician practitioner who actively assists the surgeon and goes beyond providing […]

Importance of Medical Audit

The medical audit is the systematic, critical analysis of the quality of medical care, including the procedures used for diagnosis and treatment, the use of resources, and the resulting outcome and quality of life for the patient’. The audit is a continuous cycle involving observing practice, setting standards, comparing practice with standards, implementing change, and […]

Global Surgery and Billing Guidelines

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 preoperative, intra-operative, and post-operative services routinely performed by the surgeon or by members of the same group with the same specialty. Physicians in the […]

Changes in RT and LT Modifier Usage

The Durable Medical Equipment Medicare Administrative Contractors (DME MAC) are changing the requirement that medical coders to use the RT and LT modifier for certain HCPCS codes, and that the modifiers be used when billing two of the same item or accessory on the same date of service and the items are being used bilaterally. […]

Basic Guidelines for Inhalation Treatment Billing

There are many services and products that may be billed when a patient presents with chronic asthma or other serious respiratory conditions or acute exacerbation of related symptoms. Physicians must capture all pertinent information in their documentation and, in turn, coders (or those who validate pre-coded electronic health record charges) must account for all related […]

Basic Guidelines for Billing Nebulizers

Nebulizers can be covered if the member’s ability to breathe is severely impaired. Lung diseases such as chronic obstructive pulmonary disease (COPD) and asthma are characterized by airflow limitation that may be partially or completely reversible. Pharmacologic treatment with bronchodilators is used to prevent and/or control daily symptoms that may cause disability for persons with […]

Ambulatory Blood Pressure Monitoring (ABPM) Coverage Expanded by CMS

Centers for Medicare & Medicaid Services (CMS) finalized its national coverage policy for Ambulatory Blood Pressure Monitoring (ABPM) on 02nd July 2019. ABPM is a non-invasive diagnostic test that uses a device to track blood pressure over 24-hour cycles, allowing a doctor to assess a patient’s blood pressure during routine daily living, instead of when […]

Cardiology Coding Got You Down? Use These 5 Tips For Success!

Your cardiology practice isn’t alone if you’re concerned about overcoming reimbursement hurdles in the coming year. Apart from nailing down CPT, ICD-10, and HCPCS code changes, you’ll also need a firm grasp on documentation requirements, quarterly CCI edits, regulatory updates, and revisions to modifiers, payer policies, the fee schedule, OIG watch list, and more. Understand […]

Medicare Advance Beneficiary Notice – 5 Tips for Reimbursement Success

An Advance Beneficiary Notice (ABN) is a waiver of responsibility that is issued to a patient to make sure you receive payment for services and items that are usually covered by Medicare but are not expected to be covered on this occasion. When completed properly, you should be able to recover the cost of the […]

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