When a procedure code isn’t detailed enough to tell your payer precisely what service or procedure was provided, Medicare or the private payer asks physicians to put a modifier next to the procedure code listed on their claim. This article reviews three modifiers commonly used by pain management practices.
Although ICD-11 has not yet been adopted in the United States, various countries have implemented it to enhance their health data analysis, improve public health strategies, and foster international comparability. This article covers how other countries that have adopted ICD-11 are using their data.
A recent report from the Brown University School of Public Health compared the average commercial price for low-complexity, low-intensity medical care in New York hospital outpatient departments to the same care provided in non-hospital settings, such as physician offices and ambulatory surgery centers.
Radiologists and providers who implant or program implantable medical devices should review the six new magnetic resonance (MR) safety CPT codes that went into effect January 1, 2025. The codes describe the work involved when a medical implant or metallic foreign bodies create additional risks for an MR exam.
You may have noticed that people are feeling stressed out throughout the United States. Each individual deals with stress in their own way. Most often, ICD-10-CM diagnosis codes reported for these patients may be a bit vague, especially when you are coding for a primary care physician.
When medical services are rendered, the expectation is that the facility and/or provider will be reimbursed for those services. Sometimes the reality is that a claim will be denied as it “fails to meet medical necessity” by the insurance carrier. It is always in your best interest to appeal all medical necessity denials. Note: To access this free article, make sure you first register here if you do not have a paid subscription.
A recent study published in BMC Public Health, found that patients in Colorado diagnosed with long COVID increasingly sought care from outpatient and specialist visits over hospital and emergency department visits.
