Determining Time for Anesthesia Billing

Calculating time units for anesthesia billing and coding is extremely important. A unique characteristic of anesthesia billing is the reporting of time units. Payment for anesthesia services increases with time. In addition to reporting a base unit value for an anesthesia service, the anesthesia practitioner reports anesthesia time. We shared guidelines on correctly calculating time […]


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Coding for Treatment Devices in Radiation Oncology

Coding for Treatment Devices  Treatment devices, designs, and construction may be charged during a course of therapy when documentation substantiates multiple volumes of interest/ports, the use of custom-made devices, and/or the necessity of replacement devices. Providers should bill for devices at the beginning of the treatment course and then may bill again later in the […]


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Guidelines for E/M Coding 2021

In order to reduce the administrative burden of coding guidelines, the American Medical Association (AMA) Current Procedural Terminology (CPT) Editorial Board and the U.S. Centers for Medicare & Medicaid Services (CMS) have proposed simplifications of the official evaluation and management (E/M) coding system to begin January 2021. The Guidelines for E/M Coding define the requirements […]


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Reporting Time Spent in Critical Care Service

Since critical care is a time-based code, the physician’s progress note must contain documentation of the total time involved in providing critical care service. Critical care codes 99291 (evaluation and management of the critically ill or critically injured patient, first 30-74 minutes) and 99292 (critical care, each additional 30 minutes) are used to report the […]


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Avoid Colonoscopy Billing Mistakes

Understanding the business side of medicine helps physicians run a successful practice. However, the business side of medicine is not part of the normal curriculum in training and fellowship programs. Physicians come out of training with the knowledge to treat patients but with little or no knowledge of how to get reimbursed for their services. […]


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“No Surprises Act” – Impact on Radiologist

The No Surprises Act provides new federal consumer protections against surprise medical bills and it contains key protections to hold consumers harmless from the cost of unanticipated out-of-network medical bills. Surprise billing can arise in both emergency and non-emergency situations and it is observed that 2 in 3 adults are worried about unexpected medical bills. Moreover, […]


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Billing Guidelines for Leadless Pacemakers

NCD for Leadless Pacemakers The leadless pacemaker eliminates the need for a device pocket and insertion of a pacing lead which are integral elements of traditional pacing systems. The removal of these elements eliminates an important source of complications associated with traditional pacing systems while providing similar benefits. Leadless pacemakers are delivered via catheter to […]


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Newly Added CPT Codes for COVID-19 Vaccines

Working closely with the Centers for Disease Control and Prevention, the AMA CPT Editorial Panel approved unique CPT Codes for COVID-19 vaccines as well as administration. The new CPT codes clinically distinguish each coronavirus vaccine for better tracking, reporting, and analysis that supports data-driven planning and allocation. Newly added CPT codes and their descriptors are […]


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Medicare Deductibles and Premiums Announced by CMS for 2021

The Centers for Medicare and Medicaid Services (CMS) announced that it is increasing premium and deductible costs in the Original Medicare program. Healthcare costs rise more each year, and to make up these costs, premiums, and deductibles for Medicare increase. Medicare deductibles, premiums, and coinsurance costs are adjusted annually. Medicare Deductibles and Premiums Changes Explained […]


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How to make successful Accountable Care Organization?

Value-based care is gaining more popularity in the US healthcare system and Accountable care organizations (ACOs) provide the main push for the healthcare industry away from fee-for-service towards value-based care. ACO is a very interesting model for care where groups of doctors, hospitals, and other health care providers voluntarily offer coordinated, high-quality care to patients. […]


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