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Denial Reason CO-50: Non-Covered Services Medical Necessity
Denial Code CO 50 – These are non-covered services because this is not deemed medical necessity by the payer
The Insurance Company will deny the...
CPT Category Codes by Specialty 2022
Current Procedural Terminology, more commonly known as CPT, are a set of medical codes used by health professionals, physicians, non-physician practitioners, hospitals, outpatient facilities,...
The need of Bone mineral density test
Bone mineral density test
To diagnose osteoporosis before a broken bone occurs, the only test is a bone density test, which can help to estimate...
Coders to Know Where It’s “AT” in Clean Chiropractic Claims
Ever since the publication of the Office of Inspector General’s (OIG’s) portfolio “Medicare Needs Better Controls to Prevent Fraud, Waste, and Abuse Related to...
Telehealth Coverage for Mental Health Services During COVID-19
As the global pandemic enters its fifth month, we are all feeling the strain. Staying home to slow the spread of the coronavirus may...
No-fault insurance injury/illness Denial CO-21
In the same way insurance will deny the claim with CO-21 Denial Code – This injury/illness is the liability of the no-fault carrier, when the...
Get Paid for COVID-19 Testing/Treatment of Uninsured
Payers are reimbursing providers for all COVID-19-related testing and treatment they are furnishing to their insured members, but what if the patient is uninsured?
Healthcare...
Top 15 Primary Care Podcasts You Must Follow in 2020
1. Frankly Speaking About Family Medicine
Boston, Massachusetts, United States About Podcast A weekly podcast series covering newsworthy topics in primary care medicine....
More Freedom for Therapists in New 1135 Waiver
Occupational therapists achieve long sought-after goal.
Medicare officials have knocked down another wall that blocked optimal efficiency during COVID-19 public health emergency.
The Centers for Medicare...
Imaging Services – Updated MRI CPT Codes 2021
Below is the list of MRI CPT Codes 2021 and Imaging Services to help Medicare Billers and Coders.
ORBIT, FACE & NECK
70540- W/O CONTRAST
70543- W/O...
Top 20 Critical Access Hospitals in the U.S
The Chartis Center for Rural Health recently released its annual list of the top 20 critical...
Non Covered Services Denial Code CO 46
What do you do when you are presented with a patient who needs treatment but
The patient’s insurance company will not pay for the...
CPT Codes for CT Scan and Imaging Services
Based on our experience in Medical Billing and Coding Industry, we have complied a list of CPT Codes for CT Scan and Imaging Services...
Updated List of Freestanding Emergency Rooms in Texas
What is a Freestanding Emergency Room?
A freestanding emergency department (FSED) is a licensed facility that is structurally separate and distinct from a hospital and...
Denial & Adjustment Code CO-43: Gramm-Rudman Reduction
Gramm-Rudman-Hollings Act, officially the Balanced Budget and Emergency Deficit Control Act of 1985, U.S. budget deficit reduction measure. The law provided for automatic spending cuts...
Medicare Telehealth Coding as of April 30
Healthcare providers are granted even more latitude for use of telehealth services during the COVID-19 public health emergency.
On a Friday, at month-end, the Centers...
The key to increase financial growth of an outsourced medical billing service
Practice management in medical billing is to shift the heavy lifting around getting paid, so that the physician or healthcare provider, who outsourced medical...
Telehealth care during the COVID-19 Pandemic
Telemedicine and virtual care have quickly emerged as essential equipment in being concerned in your patients while keeping yourself and your personnel secure as...
5 Private payer policies regarding the COVID-19 pandemic you should know!
We are closely monitoring private payer policies regarding the COVID-19 pandemic. The following answers are based on information from each payer’s respective website. Policies...
Insurance Denial CO 38: Services Not Authorized by Providers
Insurance Denial CO 38: Services Not Authorized by Providers
There are a number of reasons that insurance providers require prior authorization, including age, medical necessity,...
Understand and Recognize the Types of CPT Codes 2022
What are CPT Codes?
Current Procedural Terminology, more commonly known as CPT codes, refers to a set of medical codes used by physicians/providers, non-physician practitioners,...
Qualifying Payment Amount (QPA), How QPA is Calculated?
The qualifying payment amount (QPA) is the basis for determining individual cost sharing for items and services covered by the balance-billing protections in the...
Pandemic may last 2 years; remdesivir approved for emergency use
1. The COVID-19 pandemic will likely last for 18 to 24 months until herd immunity is...
CMS releases updated billing and coding FAQs for COVID-19
CMS updated it's novel coronavirus (COVID-19) billing and coding FAQs on April 9 to mirror recent rules, new waivers, and emergency regulations. The new...
New COVID-19 Antibody Testing Codes from AMA
During an emergency meeting in response to the COVID-19 crisis, the American Medical Association (AMA) convened the CPT® Editorial Panel to approve a new...
