CPT Codes

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

Terminally ill patients often rely on hospices to manage their pain and symptoms. However, a day or two in such facilities can cost hundreds of dollars. Therefore, around 1.7 million US citizens are enrolled in Medicare’s hospice program each year to receive affordable end-of-life care. So, how do hospices receive reimbursements? Hospice care specialists use

A report published by the American Academy of Home Care Medicine revealed that nearly 6.5 million people in the USA are affected by chronic wounds each year, and a vast majority of them are senior citizens aged 65 and above. Chronic wounds are caused by conditions like diabetes, pressure ulcers, and foot ulcers and require

How confident are you about using the right DME codes? We all know that proper coding can save you from payment delays. But did you know that durable medical equipment (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

The U.S. Centers for Disease Control and Prevention (CDC) reports that 11 million Americans over the age of 12 need vision correction. In another report, the CDC found that cataract is the leading cause of blindness in the USA, and around 20.5 million Americans aged 40 and above have cataracts in one or both eyes.