Are you confused about what an ABN is and when you should issue it? This guide will discuss everything you need to understand the CMS-R-131 form, from its components to its applications. However, before we go into the details, let’s first understand what exactly it is. ABN stands for Advance Beneficiary Notice. It is issued […]
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Did you know that each year, insurance payers process more than 5 billion medical claims? That is roughly 13.7 million claims each day! Can you imagine the time and effort it would take to go over each service, procedure, or product description and decide whether the claim should be paid? The US healthcare industry cannot
HCPCS Codes vs CPT Codes: Understanding the Difference Read More »
Urology services can be quite challenging to bill, especially the surgical procedures. That’s because the bundling rules and billing requirements can confuse even the most experienced billers. One such procedure is billed via CPT code 52356, and many billers make mistakes while filing claims for it. That’s why we have created this detailed guide on
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Do you want to know what the relative value unit (RVU) is? It is a primary component of the resource-based relative value scale (RBRVS). For context, the Centers for Medicare & Medicaid (CMS) and other commercial payers use it to determine payment against physician services. This guide will explore RVU in medical billing in detail,
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Preventive care is an essential checkup that helps patients maintain a healthy lifestyle. This checkup detects early signs of potential illnesses, manages chronic conditions, and reduces overall healthcare costs. However, the billing challenges still exist for the healthcare professionals providing preventive care. Hence, this blog discusses every essential detail about CPT code 99384, which is
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Sometimes billing a CPT code isn’t hard. What’s hard is remembering the prerequisites for that code and other factors that affect the usage. CPT code 29848 is one such code. The definition and usage seem simple enough. However, applying it in real-world scenarios can be challenging. That’s why we have created this guide on what
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Nursing homes are becoming more popular with the aging population. In 2020, the U.S. Centers for Disease Control and Prevention (CDC) reported that around 1.3 million people were enrolled in over 15,000 certified nursing homes. Now, there are over 25,000 nursing homes in the US. These centers provide skilled nursing, rehabilitation, and other services to
Most Common Nursing Home CPT Codes & SNF Billing Guidelines Read More »
Struggling to apply the correct Chronic Care Management (CCM) CPT codes for initial and extended care? Let us break down the differences so you can choose the right code for every situation. CCM services are a significant part of primary care. But did you know they are equally beneficial for both practices and patients? While
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“How confident are you about using the right Durable Medical Equipment (DME) codes? We all know that proper coding can save you from payment delays. But did you know that DME is usually covered by the Healthcare Common Procedure Coding System (HCPCS) instead of CPT codes? DMEs are primarily covered by HCPCS’ level II codes
Most Common DME HCPCS Codes and Billing Guidelines 2026 Read More »
Are you conducting a nuclear medicine test and totally unaware of its billing process? We have prepared a guide on the CPT code 78264 for you. This blog walks you through the code description, examples, applicable modifiers, and billing guidelines, helping you avoid denials. By the end of this guide, you will be able to
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