Coding errors accounted for 8.7 percent of improper payments made by Medicare in 2018, which cost over $2.75 billion. To avoid costly denials and potential payback demands, it’s essential to review code guidelines before submitting your claims. MBC helps many practices to pinpoint the coding issues so that there will be no Common Claim Errors. […]
The American Medical Association (AMA) announced the release of the 2019 Current Procedural Terminology (CPT) code set on 5th Sept 2018. There are 335 code changes in the new CPT edition reflecting the CPT Editorial Panel and the health care community’s combined annual effort to capture and describe the latest scientific and technological advances in […]
On September 5, 2018, the American Medical Association (AMA) released the 2019 CPT Code Set in an official press release. The main theme surrounding new codes, revised codes, and deleted codes is to increase specificity. This is a good time to understand what has changed and how it may affect your medical practice moving forward. […]
ICD-10-CM implementation brought several significant changes to the OCG (Official Guidelines for Coding and Reporting) with regard to Chapter 9 (Diseases of the Circulatory System) I.C.9.e Acute myocardial infarction (AMI). Preparing yourself for coding updates based on MI type is not sufficient. You also must learn how to apply these new codes using OGC for […]
NCCI – National Correct Coding Initiative promotes the correct coding methodologies. Furthermore, it controls inappropriate coding leading to wrong payments in Part B claims. The CMS annually updates the National Correct Coding Initiative Coding Policy Manual for Medicare Services. The Coding Policy Manual should be utilized by carriers and FIs as a general reference tool […]
There are several major issues facing compliance officers today, such as HIPAA, Stark Law, and Anti-kickback Statute issues, as well as many billing compliance issues. Billing issues continue to appear in federal government False Claims Act settlement agreements and government audit reports. Here, we’ll discuss incident-to and shared billing compliance pitfalls and focus on what […]
Prior authorization is a check run by some insurance companies or third-party payers before they will agree to cover certain prescribed medications or medical procedures. There are a number of reasons that insurance providers require prior authorization, including age, medical necessity, the availability of a generic alternative, or checking for drug interactions. A failed authorization […]
High-Deductible Health Plans (HDHP) have become increasingly popular since the Medicare Modernization Act of 2003 authorized portable, tax-advantaged health savings accounts (HSAs) designed to be coupled with these plans. Supports of HDHP advocate that, these plans as an effective mechanism for controlling health care costs by creating cost-conscious health care consumers who will look for […]
Medical Practice complains about the volume of incoming telephone calls and how much time their employees spend handling them. Why is your Medical Practice getting so many calls? It is the only way patients can make or change appointments. Patients call the office for refill authorization. Patients were distracted during their visits and are calling […]
Not only is wound coding and documentation is a daunting task, but also attracts intense inspection from auditors, with severe financial penalties for mistakes. And it’s only gotten more challenging with the new ICD-10 changes. What is included in the wound care billing guidelines 2019? An infected surgical wound, T81.4xxA, is among those 51 codes […]