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Articles tagged with "Billing"

Rheumatology Coding Corner Answer: Prolonged Service without Direct Patient Contact, Part 2

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Take the challenge. CPT codes 99358—prolonged evaluation and management (E/M) service before and/or after patient care; first hour 99359—each additional 30 minutes (list separately in addition to codes for prolonged service) Coding Rationale No—This scenario would not support the medical necessity to bill the prolonged service code(s). Keep in mind, the time that the supporting…

Rheumatology Coding Corner Question: Prolonged Service without Direct Patient Contact, Part 2

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An established, 66-year-old male patient is seen in the office for a follow-up visit for his fibromyalgia. The physician makes the decision to prescribe venlafaxine for anxiety and depression, and gabapentin for nerve pain. After the visit, the physician informs his medical assistant (MA) to contact the patient’s insurance carrier because venlafaxine requires a prior…

Tips to Manage, Prevent Medical Billing Claim Denials

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Physicians are increasingly fighting multiple forces in running a practice, and one of the most common barriers to effective revenue cycle management is frequent medical billing and claim denials. An insurance company’s denial for services places a significant strain on the financial process of the practice, which affects the bottom line. According to the Medical…

Rheumatology Coding Corner Answer: New Patient Prolonged Service Without Direct Patient Contact, Part 1

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Take the Challenge. ICD-10 Codes R76.1—Raised antibody titer L20.8—Other atopic dermatitis R20.2—Paresthesia of skin R20.1—Hypoesthesia of skin CPT Codes 99358 and 99359 Rationale The Centers for Medicare & Medicaid Services (CMS) typically does not allow separate payment for physician services that do not require face-to-face time with a patient, but as of Jan. 1, 2017,…

Rheumatology Coding Corner Answer: Coding for Incident-to Services

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Take the challenge. CPT codes: 99214-25, 20610-RT, J1030x1 Diagnoses: M05.79, M25.561 This is an established patient visit with an established diagnosis, along with a new diagnosis, which would have to be billed under the PA’s National Provider Number (NPI) and reimbursed at 85% of the fee schedule. Keep in mind that to qualify as an…

Prepare Now to Sell Your Medical Practice

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Selling a medical practice can be a lucrative endeavor. One of the most important phases of any sale transaction is the due diligence process. During this phase, a potential buyer and their advisors have the opportunity to examine the seller’s books, records and files in great detail to ensure that the buyer is comfortable purchasing…

Refocus Your Practice with Invigorating Sessions at 2017 ACR/ARHP Annual Meeting

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The landscape of practice management and coding methodologies continues to be challenging in the current healthcare environment, and rheumatology practices must maintain focus on managing an effective and efficient practice. Join us at the 2017 ACR/ARHP Annual Meeting, Nov. 3–8 in San Diego, and gain knowledge and understanding of best practices in an ever-changing environment…

Rheumatology Coding Corner Answer: Established Patient Office Visit with Acute Gout

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Take the challenge. CPT: 99214-25, 89060, 20600-RT ICD-10: M10.271, T50.2X5A, I10 This is an established outpatient visit. This encounter is coded as 99213, because it included: History—Detailed: The history of present illness is extended, the review of systems is extended, and the past medical and social histories are documented. Examination—Detailed: Seven organ systems are examined….