Osteoporosis is a bone disease that involves abnormal loss of bony tissue resulting in fragile or porous bones. Without appropriate treatment, osteoporosis can worsen. As bones get weaker and thinner, the potential risk for fractures increases. Documentation is very important and physicians must ensure timely medical documentation to ensure appropriate treatment for these patients. Medical […]
Modifier 59 is the most widely used HCPCS modifier. This modifier is associated with considerable misuse and high levels of manual audit activity, leading to reviews, appeals, and even civil fraud and abuse cases. The introduction of four ‘X’ subset modifiers is designed to reduce the improper use of modifier 59 and help to improve […]
On September 5, 2018, the American Medical Association (AMA) released the 2019 CPT Code Set in an official press release. The main theme surrounding new codes, revised codes, and deleted codes is to increase specificity. This is a good time to understand what has changed and how it may affect your medical practice moving forward. […]
The modifier 58 is defined by CPT as “staged or related procedure or service by the same physician during the post-operative period.” It may be necessary to indicate that the performance of a procedure or service during the postoperative period was a) planned or anticipated (staged); b) more extensive than the original procedure, or c) […]
As we all know, in the current age of the internet, having a website for your practice is a must. But if your website is not properly optimized then you would fall behind the competition. SEO stands for ‘search engine optimization. It is the process of getting organic traffic from search engines. In other words, […]
Patient no-show is a recurring problem for any medical practice or healthcare facility. As per the recent study, no-show rates in an outpatient setting can range between 22 percent and 35 percent, resulting in a loss of 15 percent of anticipated daily revenue. In terms of dollars, patient no-show can cost individual physicians as much […]
Patients perceive long waiting times as a barrier to obtain medical services. Keeping patients waiting can be a cause of stress for both patient and doctor. Even though the long patient wait time is not a good thing but activities like Secretary verifying insurance information or Medical Assistant preparing an exam room takes a lot […]
A modifier should never be used just to get higher reimbursement or to get paid for a procedure that will otherwise be bundled with another code. Modifier 59 describes a distinct procedural service and is used to identify procedures and services that are not normally reported together. For example, it should be used when coding […]
CMS received approval for a new Medicare Enrollment Application for physicians and non-physician practitioners (CMS-855I dated 12/2018). Many changes are minor; the major ones reduce provider burden: Eliminated reporting for advanced diagnostic imaging, Clinical Laboratory Improvement Amendments number, and the Food and Drug Administration radiology certification number Expanded instructions for individual and group affiliations to […]
A rejected claim contains one or more errors found before the claim was processed. Errors will prevent the insurance company from paying and the rejected claim is returned to the biller to be corrected. A rejected claim may be the result of a clerical error or a mismatched procedure and an ICD code. A rejected […]
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