CPT Codes

Are you confusing emergency codes with urgent care? While they might seem similar, ER E/M codes should never be used for urgent care services. Gaps in primary care, expensive emergency department visits, increasing healthcare demands, and investments have made walk-in clinics more popular. In fact, the number of urgent care centers has nearly doubled over […]

With thousands of CPT codes available for different categories, anyone can feel overwhelmed. However, accurately coding procedures is one of the important metrics to ensure timely reimbursements and avoid claim denials. That’s why most healthcare facilities opt to outsource the medical billing and coding to professionals.  But, if you want to handle the financial side

Clean claim submission is the ultimate trick to ensure rightful and timely reimbursements from insurance payers. However, healthcare is often tailored to the unique requirements of each patient. As a result, CPT codes sometimes fail to provide the specificity needed for accurate reimbursements. That’s where modifiers come in. They supply additional information to explain the

You must have scheduled evaluation and management (E/M) visits for new and established patients frequently in your career. For that, your go-to CPT code ranges must have been 99202-99205 and 99212-99215. But what about CPT code 99211, which sits right at the top of the established patient CPT code range? If you are as intrigued

Various sources have reported that the rate of claim denials for pediatric services is one of the highest among all medical specialties. According to the American Academy of Pediatrics (AAP), the average claim denial rate for pediatricians is 13%, whereas the overall denial rate in the healthcare industry is 5-10%.  Unfortunately, many of the claims

Otolaryngology is a specialized medical field focused on the ears, nose, and throat (ENT). Hence, otolaryngologists are also called ENT specialists and train in both medicine and surgery. While this specialty offers a better work-life balance than others, it is still quite demanding. Otolaryngologists spend considerable time on administrative tasks – around 14 hours per

Chronic diseases are a prevailing issue in the United States, as 6 in 10 people are suffering from at least one chronic condition. Thus, in 2015, the Centers for Medicare & Medicaid Services (CMS) introduced a value-based care program, chronic care management (CCM). The CPT code 99490 is a procedural code that you can report

Struggling to apply the correct CCM CPT codes for initial and extended care? Let us break down the differences so you can choose the right code for every situation. Chronic Care Management (CCM) services are a significant part of primary care. But did you know they are equally beneficial for both practices and patients? While

2024 has brought many interesting changes, especially in the code set for speech therapy. From eliminating CPT code 92506 and replacing it with four new specific evaluation codes to allowing speech therapists to bill for caregiver training in the absence of patients, the AMA offers a more direct approach toward reimbursements. However, there is one

Around 14% of patients discharged from hospitals are readmitted within 30 days, and it costs U.S. taxpayers more than $52.4 billion per year to care for the readmitted patients. The U.S. Centers for Medicare and Medicaid Service (CMS) has implemented several programs to reduce the readmission rate of Medicare beneficiaries. Transitional Care Management (TCM) is