Modifiers

Did you know that there are approximately 162,644 active medical residents and fellows in the U.S.? Among these, 82.3% are enrolled in specialty programs, and 17.7% are enrolled in subspecialty programs. These residents are the future of the U.S. healthcare system. Acknowledging their crucial role, the Centers for Medicare and Medicaid (CMS) introduced special billing […]

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

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

Modifiers are an integral tool that help ensure coding accuracy and specificity. However, sometimes understanding the discrete nuances of each modifier, such as what they entail, when to apply one, and when to avoid them, can be too much to understand.  Thus, the billing specialists at MediBillMD decided to start a library where you can

Medical billing requires precision and accuracy. To ensure this precision, insurance payers like Medicare ask billers to append the appropriate modifiers to the appropriate procedural code on the same claim line. One frequently used modifier in podiatry practices is the modifier Q9. Despite its frequent use, many billers face denials. The reason? Ignoring payer guidelines!

Is Medicare denying your claims for all routine foot care services? Modifier Q8 can help you avoid this problem in certain situations! One common fact about Medicare is that it excludes routine services from its coverage. Hence, countless practices regularly lose a lot of money. How many times have you experienced the same thing as

If you have ever had a discussion with medical billers, you will know that most of them agree on one thing: that billing of laboratory tests is one of the most complex. Why? Because laboratory testing is needed in almost all medical specialties. Hence, a large pool of CPT codes, ICD-10 codes, and modifiers must

Receiving denials for incorrectly using modifier 90? You are not the only one! Many healthcare providers experience this problem when they submit claims for services referred to an outside laboratory. The reason? Ignoring payer guidelines! As a result, their administrative staff face extra pressure and have to spend extra time correcting errors and chasing denials.

Healthcare is a heavily regulated industry, and if you are a Medicare-approved provider, you must be familiar with the repercussions of incorrect billing. Filing Medicare claims is hard enough, but what if you made a mistake or HAD TO render an uncovered service because the patient demanded it?  Should you accept your error or risk

Surgical procedures don’t always go as planned. How many times have you required help in the middle of an operation due to a complication? This might be routine for healthcare providers, but we know that there is one thing you all struggle with: accurately reporting the assistant surgeon’s role! Did you know that you cannot