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MEDICAL BILLING

MD Facts is about Healthcare Updates, Medical Billing and Coding Tips & Tricks, Clinical Documentation, EHR, Physician's progress notes, Medical Records and Charting, Medical Coding, Insurance Plans Information, Handling of Insurance Denials, and Insurance Updates.

No Surprises Act (NSA) and TDI Independent Dispute Resolution Mediation
The No Surprises Act protects people covered under group and individual health plans from receiving surprise medical bills when they receive most emergency services, non emergency services from out-of-network providers at in-network facilities, and services from out-of-network air ambulance service providers. It also establishes an independent dispute resolution process...
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 No Surprises Act (NSA), under certain circumstances. Cost-sharing for emergency items and services and non-emergency items and services furnished by an out-of-network provider in an...
NSA and Balance Billing Laws by State
No Surprises Act (NSA) established new federal protections against surprise medical bills and balance billing, which took effect on 1st Jan, 2022. State-regulated insurance plan (such as employer-sponsored commercial plans): If that state already has a balance billing law deemed by the federal government as meeting certain criteria, the state...
No Surprises Act (NSA), Federal IDR and how it works?
The 2020 No Surprises Act (NSA) established new federal protections against surprise medical bills and balance billing, which took effect on January 1, 2022. For emergency patients visiting a hospital or freestanding emergency room under a state-regulated insurance plan (such as employer-sponsored commercial plans): If that state already has a...
The No Surprises Act and What It Means for Emergency Rooms
The 2020 No Surprises Act (NSA) established new federal protections against surprise medical bills and balance billing, most of which took effect January 1, 2022. Below is a summary of the major No Surprises Act requirements and what they mean for you. 1- Prohibits balance billing for out-of-network emergency care (provided...
Ultrasound CPT Codes 2022
Diagnostic Ultrasound Procedures CPT Code range 76506- 76999. The Current Procedural Terminology (CPT) code range for Diagnostic Ultrasound Procedures 76506-76999 is a medical code set maintained by the American Medical Association. Ultrasound CPT Codes Range: 76506-76536 - Diagnostic Ultrasound Procedures of the Head and Neck 76604-76642 - Diagnostic Ultrasound Procedures of the...
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, hospitals, outpatient facilities, and laboratories to describe the procedures and services they perform. Specifically, CPT codes are used to report procedures and services to federal and...
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 provides emergency care. The Texas Freestanding Emergency Medical Care Facility Licensing Act was first enacted in 2009 by the 81st Legislature. An FEMC facility is a...
Understand the different types of Medical Specialties and Subspecialties
You may call them simply doctors or physicians but most of the physicians have extra expertise in one type of the medicine or another. In fact, there are hundreds of medical specialties and subspecialties of physicians to understand for Medical Billers and Coders. Every medical specialist physician shares a one...
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 & W/ CONTRAST TMJ 70336 SHOULDER, ELBOW OR WRIST (UPPER EXTREMITY, JOINT) 73221- W/O CONTRAST 73222- W/ CONTRAST 73223- W/O & W/ CONTRAST HUMERUS, FOREARM OR HAND (UPPER EXTREMITY, NON-JOINT) 73218- W/O CONTRAST 73220- W/O &...