Today physicians whether they own their practice or are employed by a hospital or larger health system are facing many challenges in the day-to-day routine. These common challenges include “How to use the EMR efficiently and getting paid”, overburden with administrative requirements, staffing, burnout, etc. despite their devotion to the practice of medicine and the […]
The physician or other qualified healthcare professional are using CPT codes from the range 99202-99499 which is called Evaluation and management (E/M) codes to represent services offered by physicians. These codes are applicable while evaluating and managing patient health. These (E/M) codes have been around for many years still reporting timed-based services is confusing. So let’s […]
It is important for all oncologists to be prepared as significant changes to the Evaluation and Management (E&M) codes E/M are into effect from January 1, 2021. Components for code selection were narrowed down to make them more clinically intuitive and to reduce variation among contractors and payers. Elements of MDM affecting coding for an […]
Basics of Worker’s Compensation Worker’s compensation, commonly known as worker’s comp, is a type of insurance that covers the treatment of injuries occurring on the job. Employers typically purchase commercial worker’s comp policies directly, although some states administer these policies. Medical billers must therefore remain aware of the worker’s comp policies for their state, including […]
Providers seeing a 2 percent payment decrease on their Remittance Advice (RA) is due to a mandatory sequestration payment reduction. Claim adjustment reason code (CARC) 253 is used to report the sequestration reduction. The code will appear as a CO 253 on the RA ‘Sequestration-reduction in federal payment’ as the reason. For the Medicare Fee-for-Service […]
Insurance will deny the claim with denial code CO 29 – the time limit for filing has expired, whenever the claims submitted after the time frame. The time limit is calculated from the date service provided. Each insurance carrier has its own guidelines for filing claims in a timely fashion. Some are as short as […]
Credentialing is a systematic approach to the collection and verification of a health care provider’s professional qualifications. The qualifications that are reviewed and verified include, but are not limited to, relevant training, licensure, certification and/or registration to practice in a health care field, and academic background. Insurance credentialing is the process of becoming affiliated with […]
You might have received a denial with claim adjustment reason code (CARC) CO B9. Possible reasons for this denial message could be: The patient is enrolled in Hospice on the date of service Medicare Part B only pays for physician services not related to Hospice condition and not paid under arrangement with Hospice entity Patient’s […]
Medical nutrition therapy (MNT) is a key component of diabetes education and management. MNT is defined as a ‘nutrition-based treatment provided by a registered dietitian nutritionist.’ It includes ‘a nutrition diagnosis as well as therapeutic and counseling services to help manage diabetes. Studies have documented an association between MNT delivered by a registered dietitian and […]
It’s an ideal industry practice that everyone who does medical coding (including physicians who code their own work) should have a periodic audit or ‘peer review’ to assure that their skill levels remain high and accurate. Accurate medical coding has a crucial role in healthcare information management and overall quality of care. Although Medical Billers […]