Medical Specialties

articles, webinars, links, files and other resources related to coding, reimbursement and compliance for medical specialties


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Acupuncture|AlternativeAllergy|ImmunologyAmbulanceAnesthesia|Pain ManagementBehavioral Health|Drug RehabCardiology|VascularChiropracticDentalDermatology|Plastic SurgeryDrug Rehab|Behavioral HealthEar, Nose, and Throat (ENT)|OtolaryngologyEmergency MedicineEndocrinologyFamily Practice|Primary CareGastroenterologyGeneral SurgeryHome Health|HospiceInternal MedicineInterventional RadiologyLaboratory|PathologyNeurology|NeurosurgeryObstetrics|GynecologyOncology|HematologyOphthalmology|OptometryOral and Maxillofacial Surgery (OMS)OrthopedicsPain Management|AnesthesiaPediatricsPhysical TherapyPodiatryPrimary Care|Family PracticePulmonologyRadiologyRheumatologySkilled NursingUrology|Nephrology


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recent articles

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CPT 10-Year Historical Content - Now Available!

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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 ...

tags  Topic: Auditing    Topic: CPT Coding   

Inadequate Exclusion Screenings Could Put Your Practice at Risk

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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.

tags  Specl: All Specialties    Specl: Chiropractic    Topic: Compliance   

Q/A: How do we Bill Massage Services?

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Question: We are adding a massage therapist soon and have some questions about billing their services.

tags  Topic: CPT Coding    Topic: Procedure Coding   

Billing for Telemedicine in Chiropractic

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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.

tags  Specl: Chiropractic    Topic: CPT Coding    Topic: E+M Documentation and Coding    Topic: Modifier Coding    Topic: Procedure Coding    Topic: TeleMedicine   

Q/A: Can Chiropractors Bill 99211?

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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...

tags  Specl: Chiropractic    Topic: CPT Coding    Topic: E+M Documentation and Coding   

Non-Surgical Periodontal Treatment

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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 ...

tags  Specl: Dental    Specl: Oral and Maxillofacial Surgery   

Who Knew? There are Three Types of Add-On Codes

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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 ...

tags  Topic: Claims Processing    Topic: Coding    Topic: CPT Coding    Topic: Procedure Coding   

Denials due to MUE Usage - This May be Why!

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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 ...

tags  Payer: CMS|Medicare    Specl: All Specialties    Topic: Appeals    Topic: Auditing    Topic: Coding    Topic: Denial Management    Topic: Modifier Coding    Topic: MUE - Medical Unlikely Edit   

CMS Report on QPP Shows Increasing Involvement

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MIPS 2018 participation increased according to the final report issued by CMS on January 6, 2020.

tags  Payer: CMS|Medicare    Topic: Quality Payment Program   

CPT 2020 Changes to Psychiatry Services

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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 ...

tags  Specl: Behavioral Health|Psychiatry|Psychology    Topic: CPT Coding   

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