CareHarmony’s Post

💵 Billing Tips and Tricks 💵 To use CPT code 97012 correctly, a healthcare provider must meet the following criteria: -The traction must be applied to the spine. -The traction must be mechanical in nature. -The traction must be applied for a minimum of 15 minutes. AND...

Modifier 59 is used in medical billing to indicate a "Distinct Procedural Service". It is applied to procedures or services that are separate and distinct from other services performed on the same day. Here are some guidelines on how to use modifier 59: 1. Use modifier 59 to bill for multiple procedures performed on the same day, but only if the procedures are truly separate and distinct. 2. The procedures must have different CPT codes and be performed at different sites or require different techniques. 3. Modifier 59 should not be used for procedures that are normally bundled together, such as an EKG and an echocardiogram. 4. Use modifier 59 with the CPT code for the additional procedure or service. 5. Make sure to support the use of modifier 59 with documentation in the medical record. Example: - CPT code 99213 (Office visit) + CPT code 11730 (Debridement) + modifier 59 This indicates that the debridement procedure was a separate and distinct service from the office visit. Remember to always check the specific payer policies and guidelines for the use of modifier 59, as they may vary.

The following resource provides the updated (as of October 2023) comprehensive list of CPT codes applicable to #physicalactivity related patient assessments, management, and follow up care.   What are CPT codes? Current Procedural Terminology (CPT) codes are numbers assigned to each task and service that you can get from a healthcare provider. For example, a routine check-up or a lab test has a code attached to it.   CPT codes are used to track and bill medical, surgical, and diagnostic services. Insurers use CPT codes to determine how much money to pay providers.   The same CPT codes are used by all providers and payers to make the billing process consistent and to help reduce errors.   https://lnkd.in/g7hRQa7a   #CPTcodes #PhysicalActivity

From over 35,000 implants and counting, to the latest clinical evidence from the CHAMPION, GUIDE-HF, MONITOR-HF trials and individual patient level meta-analysis demonstrating consistent hospitalization reductions along with survival benefit, it’s been incredible to see the life-changing impact this technology has had for so many people with heart failure and their families. This NCD is an essential next step in ensuring this therapy is available to even more people who need it. If you have a personal experience or perspective on CardioMEMS to share, I encourage you to do so below.   The comment period is open until May 30, 2024.    Submit NCD Comment: https://lnkd.in/g6dcNXqB   US Safety Info: https://bit.ly/3vlUlgo   #CardioMEMS #HeartFailure #RemoteMonitoring

#medicalbillingfacts #informative Some CPT(s) falls under Global Period Rule. They vary according to medical necessities of some procedures. Days of global period are as follows: 1: 0 Day(s). 2: 1 Day(s). 3: 10 Day(s). 4: 90 Day(s). For example, when billing for excision and repair codes i.e. CPT 11442, which is a excision code, has global period of 10 days. That means you can't bill another excision related code(s) within 10 days of global period. If there was a medical necessity and supporting medical records, then you can bill another excision code within the global period after appending modifier 24 with E/M code (if billed with excision code). Modifier 79 can also be billed if excision wasn't done at same site. Here at this point, DX codes play crucial role. Selecting the most suitable and valid DX is necessary for reimbursement. Follow for more facts. #medicalbilling #medicalcoding #medicalbillingandcoding #facts #medical #hipaa #modifiers #medicalnews #medicalbillingtraining 

True or False?! Drop your answers in the comment below. Our recent webinar highlights key changes in the AMA’s 2024 CPT codes. Discover what’s new in billing for medical services and procedures, and sign up to catch the next webinar! https://brnw.ch/21wHgVC

ICYMI: significant changes were published in CPT Assistant related to unlisted CPT codes 💡✨ Curious about what’s new? Click the link below to get the full scoop and stay ahead! 📘👇 https://lnkd.in/eR9NdKcb #MedicalCoding #CPT2024 #BillingAndCoding

Establishing Medical Necessity - Its All in the Documentation I've counseled hundreds of providers over the years regarding documentation. My advice is always centric around documenting the need for treatment and the consequences of failing to establish the treatment. It is also important to explain all of the co-morbidities that are present with the patient to establish a portrait of the case. All too often I have read treatment records that describe the procedure itself. While doing so can produce a lengthy note, reciting what was done in the notes is already known from the CPT, HCPCS or CDT codes that are used on the claim. While it may appear that you are providing a thorough record, you are reciting what the standardized code on the claim form already references. Representing medical necessity is often justifying the cost of the item or service to a health or dental plan. That is a different type of note than you may be used to writing, but it is necessary to obtain payment today for services that are costly and part of the prior authorization process.

When it comes to medical savings accounts, there are 3 basic types - HSAs, FSAs and HRAs. All provide a tax-advantaged method for employees to cover out-of-pocket medical expenses, but each type has its own set of requirements, stipulations and differentiators. This chart helps compare the key features to determine the best type of account for a group.

Did you know there are more than 11,000 Current Procedural Terminology (CPT) codes? It's true! According to the American Medical Association (AMA) there are exactly 11,163 codes. With so many, it's crucial to have a clear understanding of each one to ensure accurate billing and coding. A missed number or decimal can create PA denials or delays in both authorizations and reimbursement. Luckily, most manufacturers have resources available to support offices, infusion centers or HOPDs to ensure the correct codes are utilized for their products. Don't let your practice suffer from inaccurate coding! #CPTcodes #medicalbilling #accuratecoding