Modifier Coding

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    Do you know? Many federal, state, and private payers report incorrect modifier use as one of the top billing errors — one that results in denials, reductions in payment, or delays in reimbursement. These claims are missing a modifier or they have an incomplete or   Read more..
    Posted on 28 May, 2018
    How to Nail Down These CPT® Modifiers Every Time
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    Separate Evaluation and Management (E/M) Services from the Rest When a provider performs an E/M service and other services including a procedure for the same patient, on the same day, you can code and bill for the procedure and the E/M service separately. You   Read more..
    Posted on 24 May, 2018
    Learn Your Way Around 5 Common Modifiers
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    Streamlining accounts receivable processes, fine-tuning patient engagement, improving staff efficiency, finessing payer relations, negotiating equitable contracts, maintaining compliance with ever-changing regulations—there’s always something. Managing a medical practice is not easy. But you can make the job easier on yourself and your staff with tips to get   Read more..
    Posted on 26 Mar, 2018
    4 Convenient Tips to Make Practice Management Easier
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    What’s the most valuable asset a practice or office manager could possess—number of years in the industry, an impressive resume, a wall of certificates? None of these hold a candle to the one tool you can’t afford to lack—a positive, constructive attitude. It’s not what you   Read more..
    Posted on 22 Mar, 2018
    The First Leadership Choice Every Practice Manager Should Make
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    “Am I at risk?” This question comes up so often when I am approached at conferences by practice managers and physicians. Many in the healthcare industry have a sense of dread when thinking about what could happen if they are targeted for a government audit   Read more..
    Posted on 20 Sep, 2017
    TCI is Heading to MGMA
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    P modifiers help to ID patient health at time of anesthesia.
    Whenever you are filing a claim that involves anesthesia administration, be sure to include a physical status (“P”) modifier on any anesthesia codes. Reason: The modifiers put a spotlight on the patient’s health at the time of the anesthesia administration. There is always the risk of adverse   Read more..
    Posted on 8 Mar, 2016
    Use P Mods to Put Patent Health Info at Forefront of Claims
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    Catastrophes that occur nearby can affect your coding.
    When a disaster strikes and you have to treat patients affected by the event, be sure you’re coding properly. Explanation: Depending on the extent and circumstances surrounding the disaster, it could affect your coding, and modifier usage, when reporting services for affected patients. To make claims   Read more..
    Posted on 2 Feb, 2016
    If Disaster Hits, You Might Need Modifier CR
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    Reduced services claims often require more than just encounter notes.
    It’s a denial that’s all too common; you submit a claim for reduced services with modifier 52 (Reduced services) appended, and all is well. Correct? Well …: The claim might pass muster with the payer; to solidify your claims against denials, however, you should always include   Read more..
    Posted on 8 Jan, 2016
    Coding for Reduced Services? Make Sure Your Documentation Is In Order
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    If provider furnishes separate E/M before repair, remember 25.
    When your physician stops a nosebleed, should you report an E/M service or CPT® code? The answer: It depends. If the patient reports to the physician with complaints of a nosebleed, and the provider stops the bleed with conventional methods such as ice or pressure, you   Read more..
    Posted on 3 Jan, 2016
    Make E/M Decision First to Plug Nosebleed Coding Holes
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    When you’re only claiming the code’s professional portion, include this modifier.
    If your physician performs a service in a location where he doesn’t pay the rent, you should be on the lookout for a potential modifier 26 (Professional component) coding situation. Why? Often, a CPT® code’s relative value units (RVUs) are broken down into a technical component   Read more..
    Posted on 26 Dec, 2015
    Put 26 to Work for Many Off-Site Services

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