How do you inform a payer about the patient being fully responsible for all the charges? Through the GY modifier! You can communicate any situation with a specific modifier. These codes are the key to avoiding complicated issues or conflicts. So, what exactly is the role of modifier GY? This two-character code indicates that a […]
What is a GY Modifier? Read More »
Dermatology medical billing is known for its intricacy due to various factors. First, it has a vast array of procedures, from routine skin checkups to complex cosmetic treatments to surgical procedures. Besides, coding is complex because you have to distinguish between medically necessary treatments and non-reimbursable cosmetic procedures. Even if we limit our talk to
Common ICD 10 Codes for Skin Tags Read More »
Another day, another anesthesia code to uncover! Anesthesia care is very common in surgical procedures, each with a specific billing code. So, if you are looking for an appropriate anesthesia code for an outpatient ophthalmic surgery, you are at the right place! Each year, more than 3 million people in the U.S. undergo cataract surgery,
Ultimate Guide to CPT Code 00142 Read More »
Are you tired of receiving denials on medical claims with modifier 59? If your answer is affirmative, then it is time to conduct an internal audit because you may be inappropriately appending every other claim with the modifier 59 in hopes of bypassing the bundling issues. This revelation may sound harsh, but it can be
What is Modifier XU in Medical Billing? Read More »
How do payers compensate different healthcare providers involved in the same patient’s care? They require billing entities to use modifiers! Did you know that there is always a modifier for a specific situation? For the longest time, modifier 59 was the only choice for indicating distinct services. However, it was often misapplied to bypass bundling
What is Modifier XP in Medical Billing? Read More »
Imagine receiving a recoupment request from an insurance payer in your mailbox or on your electronic health record (EHR) system, notifying you that $2,500 will be deducted from your next reimbursement. How would you feel? Shocked and appalled, right? Most probably, the first question on your mind will be, BUT WHY? We are here to
What is a Recoupment Payment in Medical Billing? Read More »
How often do you report CPT code 77427? Radiation therapy might be the most effective cancer treatment, but billing for it is not easy, especially with Medicare reducing its reimbursements by 23% over the last decade. The treatment involves multiple components, including planning, simulation, dosimetry calculation, treatment delivery, and management, each reported by different codes.
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Some procedures are more complex than others and may require the expertise of multiple surgeons. Modifiers help identify such procedures on the medical claim. However, there is not one modifier that fits all surgeon-related situations. As a result, while billing for surgical procedures with several surgeons, many may keep scratching their heads as to which
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Medical coding becomes more complex as you try to understand its various concepts. You start by understanding how the different coding systems work and the concept of modifiers to ensure coding specificity. However, if you are a healthcare provider just kickstarting your career in the healthcare space, you may not know that you have to
What are J Codes in Medical Billing? Read More »
Did you know that around 43 million people in the U.S. had multiple health insurance plans in 2021? Many people enroll in more than one insurance plan due to broader coverage. If you regularly attend to such patients, have you ever wondered how multiple insurance companies work together to cover the costs? The answer is
What is Coordination of Benefits (COB) in Medical Billing? Read More »
