The Suicide Prevention Resource Center (SPRC) provides numerous valuable and free primary care resources on its website. Included in these resources is a five-page guide on “Tips and Strategies for Billing for Mental Health Services in a Primary Care Setting.” Topics covered in this guide include: How to bill for diagnostic and treatment services Tips […]
CMS Establishes New Physician Specialty Code for Interventional Cardiology
The Centers for Medicare & Medicaid Services has announced (pdf) the establishment of a new physician specialty code for interventional cardiology: C3. According to an American College of Cardiology report, C3 “allows CMS to distinguish an interventional cardiologist from a clinical cardiologist when billing for Medicare services.” Previously, no such mechanism existed. As a result, […]
Proper Modifier -59 Use for Postoperative Pain Management by Anesthesiologists
In a June blog post, we noted that CMS had updated an MLN Matters article to clarify the proper use of modifier -59. When this MLN Matters article (SE1418) was released, the American Society of Anesthesiologists issued a Physician and Practice Management Memo to bring attention to the publication. In this memo, ASA also provides […]
Same-Day Billing Guidelines for Mental Health Services
Last September, CMS published a Medicare Learning Network brochure on mental health services. Included in this brochure is an informative section discussing same-day billing guidelines. Note: The information in this section, and publication, applies only to the Medicare Fee-For-Service Program, also known as Original Medicare. According to CMS, integration of the following services is an […]
What Does a Medical Laboratory Technician Do?
With the improvement in the medical health care facilities, there has been a phenomenal increase in the average life span of a person. There has been a steep increase in the diagnostic facilities and this has also spawned an increase in the need of Medical Lab Technician. The scope for a Medical Lab Technician is […]
Top Billed Chiropractic Codes: ICD-9 to ICD-10 Conversion
Priority Health, a Michigan-based health plan, provides a valuable, free resource for chiropractors. The one-page resource identifies top billed chiropractic ICD-9 codes, along with their general description, and then provides the corresponding ICD-10 diagnosis code(s). Oct. 1, 2015 was recently confirmed as the new ICD-10 transition compliance date for healthcare providers. The Priority Health resource […]
CMS Assigns Physician Specialty Designation for Interventional Cardiology
The Centers for Medicare & Medicaid Services has granted a new specialty designation for interventional cardiology, according to numerous reports, including a Society for Cardiovascular Angiography and Interventions press release. The new specialty code will allow CMS to distinguish an interventional cardiologist from a clinical cardiologist when billing Medicare for services. The designation is expected […]
Free Chiropractic Billing Resource: American Chiropractic Association’s FAQs About Medicare Program
The American Chiropractic Association provides a free, valuable Medicare coding and billing resource you can access regardless of whether you are a member of ACA. On its website, ACA answers about 20 chiropractic questions about the Medicare program. These questions include the following: Are we allowed to bill Medicare patients directly (i.e., not billing Medicare) […]
CMS Updates MLN Matters Article on Proper Modifier -59 Use
CMS has recently updated an MLN Matters article to clarify the proper use of modifier -59. There are two revisions made to MLN Matters article number SE1418 (pdf). One revision corrects a code in one of the examples provided to help guide use of modifier -59 while the other revision is an editorial change in […]
Most Frequently Reported Claims Denial Reason Codes by Payer
Here are the most frequently reported claim adjustment reason codes (CARC) for a claims denial by payer, according to data from the American Medical Association’s National Health Insurer Report Card for years 2008-2013 that address denials. Aetna — CARC 96: Non-covered charge(s). (37.2% of denials) Anthem — CARC 204: Service/equipment/drug is not covered under the […]