Most healthcare plans ask for pre-authorization for certain services rendered at a healthcare facility. The list of services may vary according to the plan and insurance company. The aim of the...
How to Write a Pre-authorization Letter for a Medical Procedure
Pre-authorization or written approval from the insurance company is required for certain medical procedures (for example, outpatient surgery, MRI, CT or PET scans, chemotherapy or radiotherapy)...
Medical Coding for Treadmill Stress Testing – An Overview
Treadmill stress testing is a diagnostic test that uses treadmill bicycle and helps physicians to check how well their patient’s heart handles the work and whether the blood supply is reduced in the...
CMS Extends 2014 Informal Review Period to November 23, 2015
The Centers for Medicare and Medicaid Services (CMS) recently announced that the 2014 Informal Review period has been extended to November 23, 2015. Individual eligible professionals (EPs),...
Major Changes Affecting 2015 E/M Coding
There occurred significant changes in CPT medical coding this year with an estimated 264 new codes, 143 deleted codes, and 134 revised codes and most of these codes do have an effect on primary care...
Coding for Alzheimer’s Disease – Important Considerations
Alzheimer's disease is a progressive brain disorder that gradually destroys memory and thinking capabilities. This condition is irreversible and the most common cause of dementia (loss of thinking,...
Digital Breast Tomosynthesis (DBT) Coding in 2015
There is a significant change in coding for Digital Breast Tomosynthesis (DBT) in 2015. Three new procedure codes have been introduced in the 2015 CPT manual to describe the physician work...
Mammograms May Lead to Over diagnosis of Breast Cancer – Finds Study
Breast cancer is the second leading cause of cancer death among American women. Reports from the American Cancer Society (ACS) (2015 statistics),point out that about 231,840 new cases of breast...
No Cardiac Stress Tests for Low Risk Adults – ACP Advises
In their new guidelines, the American College of Physicians (ACP) advises that adults who are at lower risk for heart disease need not undergo screening tests such as EKGs and other cardiac stress...