Modifiers are used in medical billing for identifying procedures that have been altered, without changing the core meaning of the code(s) submitted. Proper modifier use is crucial in claims submitted for chiropractic treatment. Many providers leverage chiropractic...
Medical Billing
What is a Denial in Medical Billing?
Effective denial management in medical billing is crucial for ensuring timely reimbursements and minimizing financial disruption for both healthcare providers and patients. A denial occurs when a...
Navigating Inpatient vs. Outpatient Urology Coding: Key Differences and Best Practices
Similar to other medical specialties, urology involves various procedures and treatments including outpatient, inpatient, and urgent care, diagnostics, and consultations. Accurate coding for these...
Common Mistakes to Avoid in Substance Abuse Medical Billing
As physicians focus on providing individualized care for addiction, they also need to ensure precise documentation, proper coding, and accurate billing to reflect the services provided. Although...
Radiology Billing Compliance: What You Need to Know
Radiology covers a wide array of procedures and diagnoses, making billing compliance essential for a successful practice. Navigating the intricate coding, billing rules, regulations, and prior...
Muscular Dystrophy and Updated ICD-10 Codes: A Guideline for Practitioners
Muscular Dystrophy (MD) is a group of over 30 genetic disorders that cause progressive muscle degeneration and weakness. As healthcare practitioners, staying updated on the latest diagnostic...
Billing and Coding Tips for Spine and Pain Management
The diagnosis and treatment for spinal care can be complex, and requires a multidisciplinary team of healthcare specialists - neurosurgeon, orthopedic surgeon, physical therapist, chiropractor and...
What Can Be Done If A Prior Authorization Is Denied?
Obtaining prior authorization (PA) is a complex, time-consuming, and often frustrating process that inadvertently delays access to timely patient care. Pre-authorization requirements are stringent,...
What Are the Steps Involved in the Pharmacy Prior Authorization Process?
Healthcare providers and patients often report difficulties with health insurers regarding prior authorizations, with many consumers saying their care was either denied or delayed last year, due to...
Understand the Key Elements of ‘Incident-to’ Billing
Physician-owned multispecialty groups and practices benefit from utilizing nonphysician providers (NPPs) such as registered nurse anesthetists, physician assistants, and surgeon’s assistants. Under...
Ophthalmology Medical Coding Myths Pertaining to Foreign Body Removal
When coding for foreign body removal, it is necessary to evaluate all the potential CPT codes. After careful examination, select the most relevant codes that accurately reflect the treatment...