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 […]
The Centers for Medicare & Medicaid Services (CMS) is mailing the new Medicare cards with the (MBI) Medicare Beneficiary Identifier in phases by geographic location. There are 3 ways you and your office staff can get MBIs: Ask your Medicare patients: Ask your Medicare patients for their new Medicare card when they come for care. […]
ICD-10-CM implementation brought several significant changes to the OCG (Official Guidelines for Coding and Reporting) with regard to Chapter 9 (Diseases of the Circulatory System) I.C.9.e Acute myocardial infarction (AMI). Preparing yourself for coding updates based on MI type is not sufficient. You also must learn how to apply these new codes using OGC for […]
Medicare has come up with a new revelation this time. It is taking steps to remove Social Security numbers from Medicare cards. A health care providers also are any provider from whom the employee’s group health plan will accept medical certification to substantiate a claim for benefits. The initiative from Medicare, the Centers for Medicare […]
NCCI – National Correct Coding Initiative promotes the correct coding methodologies. Furthermore, it controls inappropriate coding leading to wrong payments in Part B claims. The CMS annually updates the National Correct Coding Initiative Coding Policy Manual for Medicare Services. The Coding Policy Manual should be utilized by carriers and FIs as a general reference tool that […]
Medical necessity denials traditionally focus on high-dollar MS-DRGs, such as those for hip and knee replacements; other MS-DRGs may also soon become targets. We have identified some of the challenges in Wound Care Medical Coding. Healthcare providers are likely to perform accurate medical coding under ICD-10 and that is when having an outsourcing medical billing coding […]
Do outpatient reimbursement for Wound Care challenges frustrate you a lot? Medicare reimbursement regulations that are currently impacting wound care practices. Wound care professionals still have to follow the coding, payment, and coverage regulations for submitting claims to traditional Medicare. Issues in Outpatient Reimbursement for Wound Care: Q. 1: Why it is crucial to know […]
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