Typically, eye care practitioners don’t use the E/M codes for what most Optometry service considers a general eye examination. They are more typically used for patient encounters where the patient presents with a medical complaint or a continuation of medical case management (i.e., glaucoma, allergy, dry eye). The five levels of E/M codes are universally […]
The goal of a well-managed radiology billing operation is to submit claims for services promptly and receive reimbursement as quickly as possible. Timely submission and prompt payment enhance the practice’s cash flow and keep the overall cost of billing at a minimum. All too often, however, payment is delayed because the payer denies the claim […]
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 […]
Pre-operative evaluation and testing services may not be covered under Medicare. Primary care physicians are often asked to evaluate a patient prior to surgery at the request of the surgeon. Patients at an advanced age and those with significant medical problems face increased risk for surgical morbidity and mortality, and preoperative evaluation will depend on […]
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. […]
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 […]
Osteoporosis is a bone disease that involves abnormal loss of bony tissue resulting in fragile or porous bones. Without appropriate treatment, osteoporosis can worsen. As bones get weaker and thinner, the potential risk for fractures increases. Documentation is very important and physicians must ensure timely medical documentation to ensure appropriate treatment for these patients. Medical […]
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. […]
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) […]
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