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Billing for Worker’s Compensation

Posted by January 11, 2021January 11, 2021Medical Billing Services

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 […]


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What is Medicare Sequestration?

Posted by January 6, 2021January 6, 2021Medical Billing Services

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 […]


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Handling Timely Filing (CO 29) Denials

Posted by January 4, 2021January 4, 2021Medical Billing Services

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 […]


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Why CAQH is Required for Provider Credentialing?

Posted by December 31, 2020December 8, 2021Medical Billing Services

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 […]


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Handling Denial B9 with Modifiers GV and GW

Posted by December 30, 2020December 13, 2021Claims Denials, Medical Billing Services

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 […]


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Medical Nutrition Therapy (MNT) CPT Codes

Posted by December 29, 2020July 29, 2021Medical Billing Services

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 […]


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Importance of Medical Coding Audit

Posted by December 22, 2020June 15, 2021Medical Billing Services

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 […]


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How to Increase Reimbursement for Telephone Calls?

Posted by December 21, 2020December 21, 2020Medical Billing Services

CMS recently announced that it will provide parity in payment for telephone/audio-only services. Specifically, Medicare payment for the telephone evaluation and management visits would be equivalent to Medicare payment for office/outpatient visits with established patients’ effective March 1, 2020. This means that payment for CPT codes 99441-99443 would increase from a range of about $14-$41 […]


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Newly Approved Telehealth Services During The COVID-19 Pandemic

Posted by December 16, 2020Medical Billing Services

The Centers for Medicare & Medicaid Services on 14th Oct 2020, announced that it has expanded the list of telehealth services that Medicare will pay for during the COVID-19 public health emergency. Medicare will begin paying eligible practitioners for these 11 newly approved telehealth services delivered via telehealth, including certain cardiac rehabilitation and monitoring services. […]


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Billing for Audio-only Telehealth

Posted by December 10, 2020May 10, 2021Medical Billing Services

The Centers for Medicare & Medicaid Services (CMS) made many changes to adapt patient care amid the COVID-19 pandemic. Expanding Medicare coverage to include a range of services through audio-only telehealth visits is one of them. Let’s understand some of the basic coding guidelines for audio-only telephone visits: CPT Code 99441-99443 -audio-only telehealth Code Description […]


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