Chemotherapy Administration Coding Guidelines 2022

The Centers for Medicare & Medicaid Services (CMS) recently published revised coding guidelines for CPT codes 90000 – 99999. In this Blog, we shared CPT codes applicable for Chemotherapy Administration Coding and minor updates in guidelines. Chemotherapy Administration Coding Guidelines 2022 Reporting Initial Service Code The CPT codes 96360, 96365, 96374, 96409, and 96413 describe […]

Billing Telehealth Visits Post Pandemic

The COVID-19 pandemic and the accompanying social distancing protocols catalyzed a shift toward remote care hence resulting in the exponential growth of Telehealth services. Governments and private payers sought to maintain access to care during this period by removing regulatory barriers and reforming payment policies. But after the pandemic, in recent months, outpatient visits by […]

Exclusion of Ground Ambulances from No Surprises Act

Congress passed the ‘No Surprises Act,’ which prohibits most surprise out-of-network billing for plan years beginning in 2022. Surprise bills occur when a patient receives care from an out-of-network provider or facility during an emergency visit or while receiving non-emergency care at an in-network hospital or facility. In these cases, patients may face balance billing […]

Medicare Coverage for Over-the-Counter COVID-19 Tests

Over-the-Counter COVID-19 Tests and Medicare As per the government’s ongoing efforts to expand Americans’ access to free testing, people in either Original Medicare or Medicare Advantage will be able to get over-the-counter COVID-19 tests at no cost starting in early spring. Under the new initiative, Medicare beneficiaries will be able to access up to eight […]

Expanded Coverage of Lung Cancer Screening with LDCT

Lung cancer is one of the most common cancers and the leading cause of cancer-related death in both men and women in the United States. This screening is aimed at the early detection of non-small cell lung cancer. On 10th Feb 2022, the Centers for Medicare & Medicaid Services (CMS) announced a national coverage determination […]

2022 Coding Update for CPT 99211

While code descriptors are never big news, one key change to a low-level office/outpatient (E/M) service code descriptor that came into effect on January 1, 2022, could be a welcome change for your practice. The revision is the level one office/outpatient E/M code for established patients. In 2022, the CPT 99211 descriptor reads as, office or […]

Managing Patient Billing Challenges

Healthcare providers focus on providing high-quality, equitable, and safe care as patient care and patient satisfaction are the ultimate motives for running practice. Patient billing is an important part of the care experience, where most practices face challenges day-to-day basis. Most of the surveys focusing on patient satisfaction report that patient bills can be difficult […]

If COVID is Ebbing Away, What Does It Mean for Telehealth Codes?

During the COVID-19 pandemic, mandatory social distancing and the lack of effective treatments have made telemedicine the safest interactive system between patients and providers. Government authorities dramatically expanded telemedicine access during the pandemic. But as COVID is ebbing away and public health emergencies (PHE) in many states are ending, how does it will impact telehealth […]

Most Favored Nation (MFN) Model

As an attempt to lower drug costs, the Centers for Medicare & Medicaid Services (CMS) released an interim final rule that implements a new payment model, known as the Most Favored Nation (MFN) Model. Its approach is to pay no more for high-cost Medicare Part B drugs and biologicals than the lowest price that drug […]

Evaluating Regulatory Risks while Outsourcing

It’s quite common for healthcare providers to outsource their billing activities to a medical billing company. Billing and coding for various medical specialties are challenging tasks due to billing guidelines, payer reimbursement policies, updated ICD-10 codes, and accurate use of procedure codes & modifiers. An orthopedic surgeon recently remarked that he was thinking about outsourcing […]

We Excel In

We Dominate Over

Our Reach

Insightful Blogs

Interesting Reads

Read our latest medical billing services and RCM related blogs