As 2022 is ending, it’s time to review our blog posts for this year. We stay up to date with the Medical billing and Coding changes and standards. Providers, billing staff as well as all medical coding companies need to be up to date with the changes in billing and coding standards. Our informative articles are also featured in BC Advantage Magazine.
Check Out The Top 10 Blog Posts We Published in 2022.
- What Is Retro Authorization in Medical Billing?
Retroactive authorization refers to requests made to the insurers for approval after the patient’s treatment has been provided and the specified period of time has ended. Insurance verification and authorization companies stay updated on such changes to help practices manage the retro-authorization request process efficiently. Retro-authorization requests should be made through the standard authorization request channels – phone, fax, or payer portal.
- What Are the Different Types of Denials in Medical Billing?
Claim denials and delayed or incorrect reimbursements from payers are the results of inefficient coding and billing. Claim denials can be hard or soft. A hard denial is when the insurance refuses to pay the claim because the service is not covered. Soft denial is when an insurance company reviews a claim and rejects payment due to an issue like missing data or lack of documentation. Other common causes of claim denials are – missing or invalid claims information, medical coding errors, duplicate claim or service, lack of coordination of patient benefits, and more.
- Predetermination vs. Prior Authorization
Prior authorization or “pre-auth” and predetermination occur before the clinical event or provision of the service. Pre-authorization is a process that insurance companies use to determine whether a patient is eligible to receive certain procedures, medications, or tests, except in an emergency. A predetermination is a formal review of a patient’s requested medical care compared to their insurance’s medical and reimbursement policies (MGMA). This blog discusses the difference between both the processes.
- What Are the E/M Coding Changes Coming in 2023?
Evaluation and Management (E/M) services include office visits, hospital visits, home services, and preventive medicine services. The updated E/M guidelines for 2023 aim to simplify and streamline coding and documenting for E/M services and are being welcomed by physicians and providers of medical coding services. In this blog, our team discusses the 2023 E/M Code updates that will reduce documentation burden.
- Latest Psychotherapy Codes 2022
Psychotherapy is often combined with medication or other therapies for better results. All mental health professionals including psychologists, psychiatrists, nurses, and social workers utilize medical coding services to submit clean claims for psychotherapy services to health insurers. This blog discusses the 2022 psychotherapy CPT codes.
- Common CPT Codes and Fee Schedules/Reimbursement Rates for a Medical Billing Service
Physical therapy faces a 3.5% cut in the 2022 Medicare physician fee schedule. These payment reductions make reliable physical therapy medical billing services more relevant. This blog provides a list of CPT codes that are frequently used by physical therapists such as 97110, 97112, 97140, 97161, 97530, 97116, 97150, 97750, and more.
- New Procedure Codes That Will Become Effective in 2023
The Centers for Medicare and Medicaid (CMS) has released the FY 2023 ICD-10-PCS codes and procedure coding and reporting guidelines, effective from October 1, 2022, through September 30, 2023. There are 331 new and 64 deleted codes, totaling 78,496 ICD-10-PCS codes for 2023. The updated ICD-10-PCS code set also features added codes for therapeutic agents and several vein introduction codes.
- Dental and Medical Billing Guidelines for Frenectomies
Frenectomy procedures are performed primarily on infants, and it involves the removal of one or both frena from the mouth. This blog highlights key CPT and ICD-10 codes to report the diagnosis and treatment procedures for frenectomy in medical bills. Frenectomy is considered as medically necessary, when accompanied by symptoms such as – difficulty feeding/eating, difficulty chewing (mastication), difficulty swallowing, and speech impairment or difficulty with articulation.
- What Are the CDT codes to Report Bone Grafts?
Bone grafts are used in combination with endodontic, oral surgery, implants and periodontal procedures. When billing bone grafts, you must use the most up-to-date codes, while avoiding unlisted, unspecified and nonspecific codes. In addition to selecting the right CDT code, dentists have to also report the correct ICD-10 code to indicate the diagnosis.
- Changes in Emergency Department E/M Coding in 2023
Evaluation and management (E/M) CPT codes are reported on insurance claims by a wide range of specialties to obtain payment for services performed in the office or other outpatient setting. Starting January 1, 2023, E/M treatments performed in outpatient and office settings will be carried over across all health care settings, including hospitals, emergency departments, nursing facilities and patients’ homes. The coding and documentation updates for E/M services in 2023 aim to reduce the administrative burden for providers. Read this blog for more information on the changes in Emergency Department E/M coding in 2023.
Stay tuned! Our blog session features the latest news/updates, tips, opinions/reflections, resources, and reviews.
This post first appeared on Medical Billing And Coding Outsourcing Blog | Medi, please read the originial post: here
