Medicare Diabetes Screening Billing Guidelines

Medicare Diabetes Screening Billing Medicare Part B covers patients with certain diabetes risk factors or diagnosed with pre-diabetes. But note that patients previously diagnosed with diabetes aren’t eligible for diabetes screening benefits. Medicare covers 1 screening every 6 months for patients diagnosed with pre-diabetes and 1 screening every 12 months if previously tested but not […]

HIPAA Compliant Ophthalmology Medical Billing Services

Basics of HIPAA Medical Billers and Coders (MBC) being a leading medical billing company manages all revenue cycle management activities in HIPAA compliant way. In this article, we shared the basics of HIPAA compliance, and how selecting HIPAA-compliant ophthalmology medical billing services can help to receive accurate insurance reimbursements while reducing the chances of payer […]

Preventive Medicine Services Coding Guidelines

Basics of Preventive Care Preventive care helps detect or prevent serious diseases and medical problems before they can become major. Annual check-ups, immunizations, and flu shots, as well as certain tests and screenings, are a few examples of preventive care. This may also be called routine care. While coding, you need to understand the difference […]

Selecting E&M Based on Time

Prior to 2021, the time associated with CPT codes 99202-99215 was based specifically on the typical face-to-face time the physician/qualified health care professional (QHP) spent on the day of the encounter. After 2021, providers may select the level of office and outpatient evaluation and management (E&M) services based on either time or medical decision-making. In […]

Billing for Surgical Assistants: What you should know?

Surgical Assistants Practices lose insurance reimbursement by incorrectly billing surgical assistants. In such cases, the major reason for claim denials is to use the wrong modifier/ not use the modifier. In this blog, we tried to cover every aspect of billing for surgical assistants including defining surgical assistants, billing guidelines, reimbursement policies, and accurate use […]

Medicare SNF Billing Coverage 2022

Medicare Part A covers skilled nursing and rehabilitation care in a Skilled Nursing Facility (SNF) under certain conditions for a limited time. Coverage for care in SNFs is measured in ‘benefit periods’ or sometimes ‘spell of illness. In each benefit period, Medicare Part A covers up to 20 days in full. After that, Medicare Part […]

Telemedicine Coverage and Reimbursement in 2022

Increased Scope of Telemedicine Telemedicine and telehealth describe the use of telecommunication tools including the Internet, video, and email to exchange information in the context of health care between patients, providers, consultants, and content for the purpose of education, evaluation, decision-making, and treatment. Prior to the COVID-19 pandemic, telemedicine applications had evolved to broadly cover […]

Billing Guidelines for Wound Care in 2022

Basics of Wound Care Active wound care procedures are performed to remove devitalized and/or necrotic tissue to promote healing. Debridement is the removal of foreign material and/or devitalized or contaminated tissue from or adjacent to a traumatic or infected wound until surrounding healthy tissue is exposed. These services are billed when an extensive cleaning of a […]

Avoiding Prior Authorization Denials

The burden of Prior Authorization According to a recent survey from the American Medical Association (AMA), prior authorization creates an administrative burden for healthcare practices, negatively impacting providers and delaying patient care. The survey also found that providers complete an average of 41 prior authorizations each week and spend an average of two business days […]

Reducing E/M Services Claim Denials

E/M Services Claim Denial Reasons As per the Centers for Medicare & Medicaid Services (CMS) data, approximately 15 percent of evaluation and management (E/M) services are improperly paid and accounted for almost 9.3 percent of the overall Medicare fee-for-service improper payment. Some of the common claim denial reasons are ‘similar services from multiple providers in […]

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