Examples of CPT, HCPCS and Anesthesia Modifiers. CPT code modifiers can be two digit numbers, two character modifiers, or alpha-numeric indicators.
Modifiers are a tool to provide more detail to the performance of a medical procedure or service. By using modifiers correctly and communicating specific information to the insurance carriers, medical coding companies ensure that physicians get paid appropriately for services rendered. CPT modifiers are placed at the end of a CPT code with a hyphen and may indicate the following: Correct Use of Modifiers – Points to Note Modifiers are used to provide additional information about complex medical procedures. Commonly Used CPT and HCPCS Modifiers Modifiers for Anesthesia Claims HCPCS Modifiers Anatomical Modifiers: Anatomical modifiers indicate the area or part of the body on which the procedure is performed on different sites during the same session. Examples of Modifier Use and Issues Involved Here are some examples provided by the American Academy of Professional Coders on the use of modifiers:
2017 Coding and Reimbursement Guidelines for Vascular Surgeons. Vascular surgeons perform a comprehensive range of procedures and the adoption of new endovascular techniques has led to reduced hospital stays.
Under Medicare’s value-based program, health care providers are rewarded with incentive payments for the quality of care rather than the quantum of services provided. FDA Approves Label Changes for General Anesthetic and Sedation Drugs. Anesthesiology medical billing can be complex as service providers must follow stringent federal guidelines.
Pediatric anesthesia services were in the news lately when the American Medical Association (AMA) announced that moderate sedation, when performed and properly documented, may be reported separately. In previous years, the AMA and the Centers for Medicare and Medicaid (CMS) disallowed separate reporting of moderate sedation in many situations. About 450 CPT codes were valued to include moderate sedation when performed. As of Jan. 1, 2017, CPT no longer defines moderate sedation as an inherent part of any procedure. The FDA has now approved labeling changes regarding the use of general anesthetic and sedation medicines in young children. Stay Up-to-date with ICD-10 Diagnostic Codes for Hepatitis. There is growing concern over the global hepatitis epidemic.
Viral hepatitis is diagnosed by the patient’s symptoms, physical exam and blood tests. Imaging studies such as a sonogram or CAT scan and a liver biopsy may also be used. 2017 CPT Coding Updates for Pathology and Lab Services. Providers of laboratory and pathology services such as offices or free-standing facilities, hospitals, skilled nursing facilities and comprehensive outpatient rehabilitation facilities are impacted by several CPT code changes in 2017.
Coding teams in reliable outsourcing companies that provide pathology medical coding and billing services are up-to-date with these code changes which include deletions, revisions and additions. Here is a summary of these updates: Molecular Pathology Revisions have been made to Molecular Pathology Guidelines including the deletion of three Tier 1 Molecular Pathology CPT codes (81280-81282) and the addition of a new Tier 1 CPT code (81327) to report SEPT9 (Septin9) methylation analysis.81327, SEPT9 (Septin9) (for e.g., colorectal cancer) methylation analysis.
Maximize Cardiology Reimbursement with New CPT Codes in 2017. High-Risk Pregnancy - ICD-10 Coding Changes in 2017. One of the most challenging areas for coders in medical coding and billing companies is obstetrics and gynecology medical billing and coding.
Effective October 1, 2016, the guideline for “Prenatal outpatient visits for high-risk patients” has been replaced with the title of “Supervision of High-Risk Pregnancy,” and includes additional guidance. Chapter 15 of ICD-10-CM contains codes pertaining to Pregnancy, Childbirth and the Puerpernium (O00-O9A): O00-O08, Pregnancy with Abortive OutcomeO09, Supervision of High Risk PregnancyO10-O16, Edema, Proteinuria and Hypertensive Disorders in Pregnancy, Childbirth and the PuerperiumO20-O29, Other Maternal Disorders Predominantly Related To PregnancyO30-O48, Maternal Care Related To the Fetus and Amniotic Cavity and Possible Delivery ProblemsO60-O77, Complications of Labor and DeliveryO80-O82, Encounter for DeliveryO85-O92, Complications Predominantly Related To the PuerperiumO94-O9A, Other Obstetric Conditions, Not Elsewhere Classified.
High-Risk Pregnancy - ICD-10 Coding Changes in 2017. Medical Billing and Coding for Telehealth Services in 2017. Recent reports indicate that the telehealth trend is growing across America, especially in rural areas.
Many states have passed a telehealth parity law, which allows providers to be eligible to receive reimbursements for telehealth at the same level as in-person services. While medical coding outsourcing can ensure appropriate reimbursement for telehealth services, providers need to be aware of the new codes that the Centers for Medicare & Medicaid Services (CMS) added in the CY 2017 proposed Physicians Fee Schedule (PFS) and other changes for the year. New place of service (POS) code: Starting January 1, telehealth services should be reported using a new place of service (POS) code. POS 02 is the location where health services and health-related services are provided or received through telecommunication technology.
CMS permits telemedicine services to be performed on a Medicare beneficiary only in an approved site. Challenges of Coding Traditional and Laparoscopic Colorectal Surgery. With in-depth and updated knowledge of payer rules and accurate assignment of CPT codes, modifiers, and diagnoses codes, medical billing and coding companies ensure clean submission of general surgery claims for correct payment.
Laparoscopic-assisted colorectal surgery, widely performed in the U.S. for the treatment of colon cancer, is in the news in the fight against opioid use. MedPage Today recently reported on research which found that a single-dose, non-opioid was linked to improved outcomes in patients undergoing laparoscopic colorectal surgery. On February 8, 2017, the Food and Drug Administration released an updated action plan to address the opioid crisis. This latest step includes efforts aimed at consumers and providers to reduce opioid abuse, addiction, and injury or death. New CPT Codes for Dialysis Circuit Interventions in 2017.
Surgeons who perform dialysis access and management procedures and the medical billing and coding companies that serve them have to deal with several new CPT codes for dialysis circuit interventions in 2017.
According to the CPT manual, the term ‘dialysis circuit’ refers to both arteriovenous fistula and arteriovenous grafts. Dialysis circuits can be placed at different areas in the forearm, elbow, and upper arm. The arteriovenous (AV) dialysis circuit is the most commonly used one and provides easy and repetitive access to perform hemodialysis (HD), improving the efficiency of the procedure. Beginning at the arterial anastomosis, the AV dialysis circuit extends to the right atrium. Medical Billing Services. Outsource Strategies International (OSI) is a Medical Billing Company that offers medical billing services for a wide range of specialties including, Orthopedics, Radiology, Allergy and Sleep Medicine, Cardiology, Critical Care, Family Practice, Geriatrics, Obstetrics, Pain Management, Physical Therapy and much more.
Working hard and being meticulous at our work is what makes our services successful. We take pride in hiring the right people to manage our client’s accounts, people with knowledge and integrity. To achieve the best possible outcome for each of our clients, our medical billing outsourcing services covers all aspects of Revenue Cycle Management including:
Know Ob-Gyn CPT Code Changes in 2017 to Optimize Reimbursement. Ob-Gyn practices face many challenges relating to both practice and reimbursement. In addition to Meaningful Use and value-based reimbursement, 2017 has brought many changes in obstetrics and gynecology medical billing and coding. While medical billing and coding outsourcing can help providers take advantage of new reimbursement opportunities, it’s important that Ob-Gyns are well-informed about these updates. Key CPT Codes Changes for Ob-Gyn in 2017 Removal of moderate sedation symbol for certain codes: Previously, a bull’s eye symbol indicated that the ob-gyn procedure includes the moderate sedation service. Choose the Right Medical Codes for Polyp Removal. The Colorectal Cancer Control Program (CRCCP) of the Centers for Medicare and Medicaid has increased colorectal (colon) cancer screening rates among men and women aged 50 years and older.
This has resulted in an increase in the number of polyps detected. Polyps are removed using various techniques, and reimbursement depends on the polyp removal method. Critical Care Billing and Coding - Guidelines to Avoid Denials. Many critical care services cannot be billed separately, but the time spent on providing these services counts when it comes to payment. Today, most physicians rely on medical billing companies to simplify the complex process of critical care medical billing. Definition The CPT definition of critical care service is: the direct delivery by a physician(s) medical care for a critically ill or other qualified health care professional of medical care for a critically injured patient. Implement 2017 CPT Code Updates for Diagnostic Radiology. Technological advancements have flooded the field of diagnostic and interventional radiology in recent years and new codes have been created to accommodate these changes.
Reliable medical coding companies keep track of these changes as they are well aware that using the new diagnostic radiology codes is crucial to help radiologists maximize revenue opportunities and minimize audit risks. Moreover, in the radiology environment, errors in coding can lead to high claim denial rates and impact profitability in the long run. Billing and Coding Tips for Spine and Pain Management. Pain management medical coding is critical for diverse clinical specialties including neurology, radiology, orthopedics, spine surgery and others. For timely reimbursement of complex spine and pain management procedures, ambulatory surgery centers (ASCs) should ensure proper claims submission with accurate medical codes.
Spine-related pain can be associated with nerve root compression, facet arthropathy, and intervertebral discs among other conditions. Diagnostic spinal procedures offered may include lumbar puncture, myelography, discography, biopsy and aspiration along with plain film radiography, nuclear medicine, CT, and MRI studies. ER Billing Complaints on the Rise – What Physicians should Watch out for. Recent reports indicate several instances of emergency room (ER) billing mistakes. Documenting Food Allergies with ICD-10 Codes. Different food items and special dishes play a key role in any celebrations; let that be Christmas dinner, New Year’s Eve, or even a birthday party. But for people who have food allergies, such occasions may not be very enjoyable. Pneumonia - Code It Right in ICD-10-CM. ICD-10 Chiropractic Codes to Document Winter Vehicle Accidents. Detailed Clinical Documentation Crucial for Accurate Abscess Coding.
The most common skin and soft tissue infections that family physicians treat are superficial and small abscesses. Reporting Back Pain in ICD-10-CM. Orthopedic, physical therapy, and chiropractic practices see a large number of patients reporting with back pain. This common health concern is a leading cause of disability among U.S. adults of all ages. Common Revenue Cycle Management Challenges and How to Overcome Them - mosoutsource. With the multiple organizational and regulatory compliance challenges confronting healthcare providers, medical billing companies need to go the extra mile to ensure effective revenue cycle management (RCM) for their clients.
A transparent, efficient medical billing process is crucial to prevent claim denials and maximize financial health. RCM refers to all the business processes involved in running a practice—from patient eligibility verification, claim processing, claim submission, and revenue generation. Get to Know the Strangest ICD-10 Codes. Strategies to Minimize Vaccine Administration Losses. Many physicians’ practices opt to outsource medical billing to save expenses on overhead, staff, hardware and other infrastructure. When it comes to vaccine administration, things are quite challenging. With flu season in full swing, doctors’ offices are struggling to align vaccine administration costs with revenue. A report published in Medscape in 2011 noted: “Issues in vaccine reimbursement threaten to disrupt this critically important service, a result of the high price of vaccines and the risk involved in maintaining a large, expensive inventory”. A study by leading insurer athenahealth, which analyzed trends in vaccine reimbursement to pediatricians over a 2 – year period from several payers, found that the rate of underpayment was more than 47% .
Coding the Dental Examination Visit Correctly. Strategies for Surviving End of ICD-10 Flexibilities by Outsource Strategies. Articles. Detailed Clinical Documentation Crucial for Accurate Abscess Coding. Flu Season is Here – Changes in CDC’s Immunization Guidance & Codes. In the United States, the flu season starts during the fall, with influenza viruses increasing in October and November, and continuing to be active till as late as May. The best way to prevent the flu is by getting a flu vaccine, and this year, the Centers for Disease Control and Prevention (CDC) is encouraging people to get their flu shots as early as possible.
During the 2015-16 flu season, national influenza vaccination coverage decreased to 45.6% (about 144 million people), which was a 1.5 percentage point decrease compared with the 2014-15 season (47.1%). Dental-medical Cross Coding can Increase Dental Practice Reimbursement. Prepare for Payer Audits and Avoid Compliance Issues. 2016 HCPCS Coding Corrections. Medicare Part B Now Covers Really Expensive Drugs. ICD-10-CM - Overview, Significance and Top Diagnostic Codes. CMS Proposes Changes to Two-Midnight Rule for 2016. ICD-10 Medical Coding for Myocardial Infarctions. Transitional Care Management Services – Coding and Documentation. Importance of HIPAA Compliance Document in Medical Billing. Key ICD-10 Documentation Elements for Major ED Encounters. Improving Physician-CDI Engagement for Smooth Transition to ICD-10 Documentation. Are Healthcare Providers Ready for the Transition to ICD-10? - Seekyt. Physicians Not Yet Ready for the ICD-10 Transition. Gastroesophageal Reflux Disease (GERD) – Diagnosis and Coding.
Google Glass for Better EHR Management. CMS Proposed Changes to Home Health Payment System. Getting Reimbursement for Unlisted Procedures. Medicare Overpayment and Measures to Avoid Penalties. Shared Medical Appointments – Pros and Cons. How to Grow Your Chiropractic Practice. Attention Deficit Hyperactivity Disorder - Medical Coding. Safeguarding Your Practice against Data Security Breaches. How to Find an Ideal Medical Coding Company. Changing U.S. Healthcare Trends to Watch for in 2015. Critical Role of Insurance Verification Process in Orthopedic Practices.
How to Write SEO Content. Enjoying Summer the Best Possible Way - Safe and Healthy. Prepping Your Medical Website for the New Season. Solutions to Mitigate Rising Dialysis Costs. Rising Physician Burnout Blamed on EHR. Important Considerations When Switching an EHR System. How to Improve Patient Collections. How Mobile Applications are Changing Healthcare.
AMA Releases CPT Codes for Advanced Care Planning Services. How can Medical Billing Companies be more efficient? Understanding HEDIS Better. How ASCs Can Improve their Revenue from Increased Patient Volume. Strategies to Improve Revenue Cycle Management. Most Practices Replacing Their Medical Billing Software. Medical SEO for Hospitals. How to Improve Your Medical Practice. Steps to Select the Right Medical Billing Firm. Tips To Maintain Patient Interaction while Using EHR. Different Types of Medical Billing Fraud and Abuse. Outsourcing Medical Billing – Pros and Cons. The Significance of Professional Medical Coding Services. The Growing Importance of Professional Medical Coding Services. What to Consider When Developing Content for Your Medical Website. How Online Billing Service Is Beneficial for Medical Practices?
Opioids Use among Returning Soldiers Studied.