Medisys Compliance

AUGUST 27, 2024

This guide provides a detailed, technical overview of the key aspects involved in CPT coding for PT, helping you optimize your practice’s billing processes. Overview of CPT Codes in Physical Therapy CPT codes are used to describe medical, surgical, and diagnostic services.

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Medisys Compliance

MAY 17, 2024

Medical Necessity: Payers may deny claims if they deem the service not medically necessary. This often involves providing clear documentation justifying the treatment plan. Eligibility Issues: Patient insurance coverage may be inactive, lack specific benefits, or require prior authorization for certain services.

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Medisys Compliance

FEBRUARY 27, 2024

Key regulations include the Health Insurance Portability and Accountability Act (HIPAA), the Stark Law, the Anti-Kickback Statute, and regulations set forth by the Centers for Medicare & Medicaid Services (CMS) and private payers. Radiology practices must stay updated on these regulations to ensure compliance.

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Medisys Compliance

JUNE 14, 2023

Implementing advanced billing software that incorporates compliance checks and built-in coding assistance can help reduce coding errors and mitigate compliance risks. Documentation and Coding Accuracy Accurate documentation and coding play a vital role in medical billing.

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Medisys Compliance

JANUARY 11, 2024

Audits: Increased scrutiny from Medicare and Medicaid for potential coding discrepancies. Documentation Burden Detailed documentation is crucial for supporting claims and ensuring compliance with regulations. Proper medical terminology and abbreviations. Efficient documentation practices and record-keeping systems.

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Medisys Compliance

APRIL 26, 2024

Essential Considerations for Accurate Outpatient Billing Accurate Documentation: Detailed and clear physician documentation is vital for accurate coding. Documentation should reflect the history of present illness, review of systems, medical decision-making, physical examination findings, and assessment/plan.

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Medisys Compliance

AUGUST 21, 2024

In 2024, the Centers for Medicare & Medicaid Services (CMS) introduced several crucial updates to radiation oncology billing guidelines. These guidelines cover various aspects of billing, including CPT codes, HCPCS codes, ICD-10 codes, and documentation requirements. Contact us today for a free consultation.

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Medisys Compliance

JULY 27, 2023

How do I ensure compliance with Kentucky Medicaid and Medicare billing guidelines? Training and education: Ensure that the billing and coding staff receive appropriate training on Kentucky Medicaid and Medicare guidelines. Documentation accuracy: Accurate and complete documentation is vital for billing compliance.

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Medisys Compliance

FEBRUARY 19, 2024

Diagnosis Drives Reimbursement: Accurately document diagnoses using ICD-10 codes that align with the group’s focus and individual client needs. Ensure diagnoses support the medical necessity of group therapy for each participant. If you treat Medicare or Medicaid patients, ensure you have the necessary knowledge and resources.

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Medisys Compliance

AUGUST 20, 2024

Common codes include: 90832: Psychotherapy, 30 minutes 90834: Psychotherapy, 45 minutes 90837: Psychotherapy, 60 minutes 90791: Psychiatric diagnostic evaluation 90792: Psychiatric diagnostic evaluation with medical services These codes must be selected based on the time spent and the complexity of the service provided.

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Medisys Compliance

OCTOBER 20, 2023

Emergency medical coders use standardized code sets like CPT (Current Procedural Terminology) and ICD-10 (International Classification of Diseases) to describe the services rendered. Thorough Documentation: Comprehensive and accurate documentation is the cornerstone of proper coding and billing.

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Medisys Compliance

JULY 17, 2024

The revised codes now emphasize the duration and specificity of the infusion, requiring detailed documentation of the time and type of drugs administered. This change aims to simplify billing and reduce the chances of claim denials. Documentation Requirements Detailed documentation is now more critical than ever.

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Medisys Compliance

JULY 31, 2024

Documentation Requirements Detailed documentation is crucial for supporting the medical necessity of immunotherapy. Comprehensive documentation ensures transparency and supports claims during audits. Some payers may require prior authorization, while others have specific documentation requirements.

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Medisys Compliance

APRIL 8, 2024

Precise Coding: Utilize the latest versions of ICD-10 (diagnosis codes) and CPT (procedure codes) to ensure accurate representation of services rendered. Detailed Documentation: Maintain clear and concise medical records that document the patient’s condition, treatment plan, and medical necessity for services.

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Medisys Compliance

MARCH 5, 2024

Payer Audits and Reimbursement Challenges in Cardiology Billing Common Challenges in Cardiology Billing Coding Complexity: Cardiology procedures often involve multiple components and intricacies that require accurate coding to reflect the level of service provided.

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Medisys Compliance

AUGUST 29, 2024

E-visit Codes: Typically, there are specific codes designated for e-visits that cover remote evaluations and management services. Ensure that the documentation accurately reflects the nature of the service provided and the time involved. These codes vary based on the time spent on the visit and the level of care provided.

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Medisys Compliance

JULY 9, 2024

Angina pectoris with documented spasm I21.01: ST elevation (STEMI) myocardial infarction involving the left main coronary artery I21.4: Angina pectoris with documented spasm I21.01: ST elevation (STEMI) myocardial infarction involving the left main coronary artery I21.4: Use detailed clinical documentation and coding resources.

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Medisys Compliance

MAY 27, 2024

Streamlining Your GI Billing Process Patient Insurance Verification: Before each encounter, confirm the patient’s insurance is active and understand their GI coverage details (deductibles, co-pays, covered services). Accurate Documentation: Maintain thorough medical records for each patient.

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Medisys Compliance

AUGUST 23, 2024

Involving clinical staff in these audits can also provide insights into the accuracy of clinical documentation, which directly impacts coding precision. Upon audit, it was found that the codes used did not align with the documented treatment protocols. This ensures that the coding reflects the actual services provided.

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Medisys Compliance

AUGUST 1, 2024

Accurate and compliant group therapy billing requires a comprehensive understanding of patient eligibility, group composition, session structure, provider qualifications, and meticulous documentation. Session Structure: The duration, frequency, and content of group sessions impact billing and documentation requirements.

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Medisys Compliance

JULY 23, 2024

CPT Code 77427: This code for radiation treatment management has been revised to better delineate between simple and complex treatment plans, ensuring appropriate billing for the level of service provided. Compliance and Documentation Tips Accurate documentation is crucial for compliance and reimbursement in radiation oncology billing.

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Medisys Compliance

FEBRUARY 21, 2024

Billing Components of CPT Code 59400 Antepartum Care: Antepartum care includes all prenatal visits and services provided to the pregnant patient before delivery. Each antepartum visit should be documented thoroughly, including the history, physical examination, medical decision-making, and any procedures or interventions performed.

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Medisys Compliance

OCTOBER 18, 2023

Following are some guidelines to follow when using this procedure code: Correctly identify the service: Ensure that the service being coded is the interpretation and report of an EKG, not the performance of the EKG test itself. Ensure accurate documentation: Accurate documentation is crucial for proper coding and billing.

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Medisys Compliance

MAY 4, 2023

Some of the common challenges include: Complex coding: Oncology medical billing requires accurate and detailed coding of diagnoses, procedures, and medications. This can be challenging due to the complex nature of cancer treatment and the need for precise documentation.

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Medisys Compliance

APRIL 23, 2024

Implement Regular Audits: Regularly audit your billing processes to identify and address any coding inconsistencies or documentation gaps. missing information, coding errors) and have a clear process for appealing denials with proper documentation. This fosters trust and reduces billing surprises.

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Medical Billing Medical Billing Outsourcing Medicare Medicare 59

Medisys Compliance

NOVEMBER 8, 2023

Mental health providers should be aware of the rules and regulations set forth by the Centers for Medicare and Medicaid Services (CMS) and other federal agencies. Payer Policies: Private insurance companies, Medicaid, and Medicare have varying policies regarding telehealth reimbursement.

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Medisys Compliance

JUNE 26, 2024

Introduction In mental health care, accurate documentation and coding are pivotal for effective treatment planning, patient care, and reimbursement. Detailed Documentation Thorough documentation of the patient’s symptoms, history, and diagnosis is crucial. Bipolar Disorder: F31.0 – F31.9; Schizophrenia: F20.0 – F20.9

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Medisys Compliance

JANUARY 9, 2024

Documentation Matters: Ensure your medical records are clear, concise, and complete. So ditch the denials and let Medisys handle the billing, while you focus on what you do best – delivering exceptional patient care. The Pillars of Success Accuracy is King: Double-check everything!

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Medisys Compliance

MARCH 15, 2024

For proper reimbursement, ensure your medical records clearly document the specific hormone or substance measured in the RIA test. Also document the medical reason for ordering the RIA test, linking it to the patient’s diagnosis and treatment plan. Stay updated on coding changes: CPT codes are periodically revised.

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Medical Billing Medical Billing Outsourcing Medicare Medicare 59

Medisys Compliance

APRIL 25, 2024

MIPS focuses on four key performance categories: Quality: This measures the quality of care you provide to your patients based on specific metrics established by the Centers for Medicare & Medicaid Services (CMS). Reporting accurate data for cardiology-specific quality measures is crucial.

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Medisys Compliance

MAY 3, 2024

This guide will equip you with the knowledge to decipher these often-confusing documents. An EOB is a document sent by an insurance company to a patient after a healthcare service is rendered. Common reasons for claim denials in behavioral health include: Lack of prior authorization for specific services.

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Physician Credentialing Company

AUGUST 12, 2024

To guarantee that every service rendered during the visit is recorded under this code, accurate documentation is necessary. These rendered services will be billed under the medical billing CPT code G0463. All these services will be billed under the 99214 CPT code. What is CPT Code 99214?

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Medisys Compliance

APRIL 1, 2024

Documentation Requirements: Maintain thorough documentation of the telehealth encounter, including the communication method (video, audio-only, etc.), Patient Consent: Ensure patients have consented to receiving telehealth services and understand potential billing implications. duration, and the nature of the visit.

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Medisys Compliance

MARCH 7, 2024

Consequently, staying informed about these updates is imperative for healthcare professionals to accurately document and bill for services rendered. For example, the addition of codes for telehealth services underscores the growing importance of virtual care delivery, especially in light of the COVID-19 pandemic.

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Medical Billing Medical Billing Outsourcing Regulatory Compliance COVID-19 59

Medisys Compliance

DECEMBER 29, 2023

Introduction The realm of cardiology encompasses a vast array of specialized services and procedures, demanding precise documentation and accurate coding for proper reimbursement. This article serves as a detailed guide, unpacking the details of this CPT code range 92920-93793 and its applications within cardiology billing.

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Medisys Compliance

JUNE 27, 2022

The Centers for Medicare and Medicaid Services (CMS) has announced a shift in its eligibility criteria for coverage of lung cancer screening using low-dose CT (LDCT), with implementation date of October 3 rd , 2022. If you need any assistance in billing for Medicare, contact us at info@medisysdata.com/ 302-261-9187.

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Medisys Compliance

FEBRUARY 13, 2024

In progress notes, document session duration, interventions, and treatment plan goals. When family members are involved, utilize specific code modifiers (-96, -97) and submit detailed clinical documentation demonstrating medical necessity. Ensure informed consent is obtained for treatment and billing practices.

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