Gastroenterology treatments are not only hard to perform, but they are also very challenging to bill. How many times have you finished a long week of complex procedures only to find that your reimbursements don’t reflect the difficult work you actually performed? That’s a common scenario in almost all gastroenterology practices. One such procedure that […]
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Many patients, especially the elderly, sometimes require prolonged treatments, which, if provided at hospitals, only burden the health systems. Therefore, medical attention is delivered to them right in their homes. This is where home health services help both patients and healthcare providers. Often, these services are provided by skilled registered nurses (RNs). CPT code 99602
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Imagine you just finished a grueling week in the clinic. You successfully diagnosed your last patient’s cervical pain, performed a precise facet joint injection, and finally provided him the relief he has been seeking for months. You documented the procedure, submitted the claim, and started your new week. However, days later, your claim is denied.
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Speech and language disorders are quite prevalent in children. According to research, almost eight to nine percent of children have speech disorders. This places a great deal of responsibility on speech and language pathologists. Unfortunately, billing for such specialized services is a challenging process, but filing accurate claims and avoiding denials can be made much
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Electrical Stimulation Therapyplays a significant role in physical therapy. The use of electrical stimulation devices is rapidly expanding in many hospitals. According to a 2023 market research, hospitals were the leading users of electrical stimulation devices, capturing 58% of the market share. These devices are primarily used for pain management, neurological care, and rehabilitation. But
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Physical therapy (PT) billing is rarely straightforward. Just when you think you have a handle on the Medicare 8-minute rule or Correct Coding Initiatives (CCI) edits, a new requirement is introduced to complicate your revenue cycle management. That’s what happened when the Centers for Medicare and Medicaid Services (CMS) created the CQ modifier. The time-based
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Chronic pain management treatments are among the most performed procedures. However, they are also one of the most difficult to bill. One specific area where many billers face difficulty is the proper coding of multi-level facet joint injections in the lumbar spine. This often involves the use of CPT code 64494. That’s why we have
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Are you an ophthalmologist struggling to get paid for the essential computerized diagnostic scans on the first try? Well, the reason for the denial can be as simple as missing a component billing modifier (26, TC), misusing a bilateral procedure modifier (50), or inadequate documentation. Most of the time, you can prevent these denials by
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Claim forms, such as the CMS-1500, serve as the backbone of the revenue cycle management (RCM) for healthcare practices. It serves key functions that expand beyond requesting payment for the rendered care services. When you submit the claim form, you initiate the payment collection process. Besides, it acts as a legal document between the provider,
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Medicare and several other insurance payers have set annual therapy limits for their beneficiaries. These thresholds ensure that only the most medically necessary outpatient therapies are rendered to patients. However, the therapies may range from occupational to physical to speech-language. So, how will the provider ensure that the therapy service’s discipline is identified accurately for
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