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 […]
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 […]
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. […]
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 […]
The basic guidelines for billing nebulizers come in two parts: the equipment must be supported by a physician’s order and documented medical need, and an in-office treatment is billed with CPT 94640 once per episode of care. Treatments running past an hour move to 94644 and 94645, and the drug is billed separately with its […]
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 […]
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 […]
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 […]
Regulatory burdens on small practices and solo providers have never been greater, including MIPS/MACRA, HIPAA, patient-centric engagement, as well as the need to comply with fee-for-service and value-based care contract requirements. In this blog, we will focus on the reduced regulatory burden for MIPS and how a systematic approach will help you to reduce HIPAA […]
Therapy Practice Accelerator is a proven, empowering system that gives therapists the missing pieces that let you build the full practice you envision. The schedules of physical therapists tend to be extremely busy. With the digital age being in full swing, your attention and focus can be pulled in many different directions affecting overall productivity. […]
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