Medical Payers & Insurance Companies
articles, webinars, links, files and other resources related to coding, reimbursement and compliance for medical payers and insurance companies
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recent articles
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January 22nd, 2020
CPT 10-Year Historical Content - Now Available!
| Published January 22nd, 2020
Did You Know?
We now offer Historical CPT Content in 2-year, 5-year, or 10-year options! Utilize access to specific CPT historical data for previous years using rules effective at that specific time. If you’ve added UCR fees to your account, you can use Historical CPT Content to view UCR fees from ...
January 21st, 2020
Inadequate Exclusion Screenings Could Put Your Practice at Risk
| Published January 21st, 2020
Exclusion screenings require far more than just checking a name on a federal database at the time you are hiring someone. Far too many providers don’t realize that in order to meet compliance requirements, there is MUCH more involved. There are actually over 40 exclusion screening databases/lists that need to be checked.
January 21st, 2020
Q/A: How do we Bill Massage Services?
| Published January 21st, 2020
Question: We are adding a massage therapist soon and have some questions about billing their services.
January 14th, 2020
Billing for Telemedicine in Chiropractic
| Published January 14th, 2020
Many large private payers recognize the potential cost savings and improved health outcomes that telemedicine can help achieve, therefore they are often willing to cover it. While there are several considerations, there could be certain circumstances where telemedicine might apply to chiropractic care.
January 14th, 2020
Q/A: Can Chiropractors Bill 99211?
| Published January 14th, 2020
Can chiropractic offices bill code 99211? Technically it can be used by chiropractors, but in most instances, it is discouraged. Considering that 99211 is a low complexity examination for an established patient, this code is not really made for the physician to use. In fact, in 2021, changes are coming for this code...
January 14th, 2020
Non-Surgical Periodontal Treatment
| Published January 14th, 2020 - Last Review/Update January 15th, 2020
AAP treatment guidelines stress that periodontal health should be achieved in the least invasive and most cost-effective manner. This is often accomplished through non-surgical periodontal treatment.Non-surgical periodontal treatment does have its limitations. When it does not achieve periodontal health, surgery may be indicated to restore periodontal health.SCALING AND ROOT PLANINGScaling ...
January 9th, 2020
Who Knew? There are Three Types of Add-On Codes
| Published January 9th, 2020
Using add-on codes with HCPCS/CPT is not as simple as 123! Although there are three different groups of add-on codes assigned by CMS, these are used to identify code edits. It is easy to see the add-on code with some codes; we can see the instructional notes and phrases such ...
January 7th, 2020
Denials due to MUE Usage - This May be Why!
| Published January 7th, 2020
CMS assigns Medically Unlikely Edits (MUE's) for HCPCS/CPT codes, although not every code has an MUE. MUE edits are used to limit tests and treatments provided to a Medicare patient for a single date of service or for a single line item on a claim form. It is important to understand MUE's are ...
January 6th, 2020
CMS Report on QPP Shows Increasing Involvement
| Published January 6th, 2020
MIPS 2018 participation increased according to the final report issued by CMS on January 6, 2020.
January 3rd, 2020
CPT 2020 Changes to Psychiatry Services
| Published January 3rd, 2020 - Last Review/Update January 7th, 2020
As of January 1, 2020, CPT made changes to the health and behavior assessment and intervention codes (96150-96155) and therapeutic interventions that focus on cognitive function (97127). If you code and audit services in this category, you must pay close attention to the changes as they include the removal and ...
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