Medicare Covered Vision Services

Medicare Fee-For-Service/ original Medicare does not normally cover routine vision services, such as eyeglasses and eye exams. Medicare may cover some vision costs associated with eye problems resulting from an illness or injury. This article covers Medicare-covered vision services for certain beneficiaries, including Intraocular lenses (IOLs); Glaucoma screenings, and other Medicare-covered services. Generally, Medicare covers […]

Why Medicare Isn’t Paying You?

There are two main categories of services for which a physician may not be paid by Medicare: Services not deemed medically reasonable and necessary Non-covered services In some instances, Medicare rules allow a physician to bill the patient for services in these categories. Understanding these rules and how to use them in your practice increases […]

Common Denials for SNF and How to Avoid Them?

Denial 1: Certification or Recertification Statement (Missing/ Lacked Information) From 2012-2014 the percentage rate of improper payments to SNF almost doubled all stemming from failure to obtain certification or recertification. General Guidelines: The Certification Statement must include that the individual requires skilled nursing (furnished directly by or requiring supervision of skilled nursing personnel) or skilled […]

Time-Based Billing for CPT Evaluation and Management

Within the guidelines of the CPT code book, CPT has stated; “When counseling and/or coordination of care dominates (more than 50%) the physician/patient and/or family encounter (face-to-face time in the office or other outpatient setting or floor/unit time in the hospital or nursing facility), then time may be considered the key or controlling factor to […]

How to use Modifier 25 Accurately for Medicare

Modifier 25 is used when a minor procedure (one with a 0- or 10-day global period) and a significant and separately identifiable evaluation and management (E/M) service are performed during the same session or day. Modifier 25 (significant, separately identifiable evaluation and management [E/M] service by the same physician on the same day of the […]

Avoid the Top 10 Modifier Mistakes – Modifier 58

Matching CPT code with an ICD 10 code, this would seem to be a very straightforward process but there are always variations/exceptions to everything. Sometimes, there are related services that the physician is performing, global periods to contend with, etc. Modifiers will clarify extenuating circumstances, which should allow for payment when they otherwise may not. […]

How accurate you can use Modifier 58 in Medical Billing?

The modifier 58 is defined by CPT as “staged or related procedure or service by the same physician during the post-operative period.” It may be necessary to indicate that the performance of a procedure or service during the postoperative period was a) planned or anticipated (staged); b) more extensive than the original procedure, or c) […]

How MBC Changing the Face of General Surgery Billing?

How MBC changing the face of General Surgery Medical Billing?

General Surgery, in the midst of forte explicit medical procedures, has not lost its sheen, and general specialists keep on being the particular decision for various surgeries. Doing negligible obtrusive medical procedures (applying creative and progressed Robotic innovation) for more noteworthy productivity, general specialists have been frequently called upon to relocate to more up-to-date mechanical […]

Acquaint Yourself with 9 New HCPCS Modifiers

A modifier is a two-digit numeric or alphanumeric character reported with an HCPCS Modifier code, when appropriate. Modifiers are designed to give Medicare and commercial payers additional information needed to process a claim. This includes HCPCS Level I (Physicians’ Current Procedural Terminology [CPT®]) and HCPCS Level II codes. A modifier provides the means by which […]

We Excel In

We Dominate Over

Our Reach

Interesting Reads

Insightful Blogs

list of medical billing companies in california