Optometry Billing in 2025: Navigating New CMS Updates for Maximum Reimbursement

With CMS 2025 updates, optometry practices face new coding changes, prior authorization expansions, and stricter compliance regulations. These updates impact reimbursement rates for eye exams, vision therapy, surgical procedures, and contact lens fittings, making optometry billing in 2025 more complex than ever. At Medical Billers and Coders (MBC), we specialize in optometry billing solutions, ensuring […]

CPT Codes for Behavioral Health Billing

CPT Codes for Behavioral Health: When it comes to the procedural aspect of billing for behavioral health services in the context of medical billing, healthcare professionals face a difficult and complex challenge. A tailored billing system that can manage pertinent Medical Current Procedural Terminology (CPT) codes and related services must be set up by providers […]

Understanding CPT Code 97597: A Comprehensive Guide

In the medical field, accurate and standardized coding is essential for proper documentation, billing, and reimbursement. One such code that plays a crucial role in wound care management is CPT code 97597. CPT code 97597, titled “Debridement (e.g., high-pressure water jet with/without suction, sharp selective debridement with scissors, scalpel and forceps), open wound, (e.g., fibrin, […]

Medical Billing for Cardioversion

Basics of Cardioversion Cardioversion is a medical procedure by which an abnormally fast heart rate (tachycardia) or other cardiac arrhythmia is converted to a normal rhythm using electricity or drugs. For medical billing purposes, cardioversion has been coded as an external and internal procedure. CPT codes 92960 (cardioversion, elective, electrical conversion of arrhythmia; external) and […]

Billing Medicare for Initial Preventive Physical Examination

Initial Preventive Physical Examination (IPPE) The initial preventive physical examination (IPPE) is a preventive visit also known as a ‘Welcome to Medicare Preventive Visit’. Medicare pays for one IPPE per beneficiary per lifetime for beneficiaries within the first 12 months of the effective date of the beneficiary’s first Part B coverage period. The IPPE may […]

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 […]

Medicare Coverage for Vagus Nerve Stimulation (VNS)

Vagus Nerve Stimulation (VNS) is a pulse generator, similar to a pacemaker, that is surgically implanted under the skin of the left chest and an electrical lead (wire) is connected from the generator to the left vagus nerve. Electrical signals are sent from the battery-powered generator to the vagus nerve via the lead. These signals […]

Billing for Continuous Glucose Monitor (CGM)

On December 28, 2021, the Centers for Medicare & Medicaid Services (CMS) published a final rule which was implemented on February 28, 2022. This final rule addressed the classification and payment of continuous glucose monitor (CGMs) under the Medicare Part B benefit for durable medical equipment (DME). This rule expanded the classification of DME to […]

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 […]

Medicare requirements for ambulance transport medical billing

Today various private and public ambulance transport services are operating in a huge number for servicing critical patients at crucial moments. These players are getting reimbursed under Medicare Part B which covers ambulance transport medical billing with certain limitations. Let’s understand Medicare Part B in more detail: Medicare Part B Medicare Part B covers emergency […]