Medisys Compliance

MAY 27, 2024

99213, 99214) Healthcare Common Procedure Coding System (HCPCS) Codes: These codes may apply for additional services like pathology analysis or stent placement. Place of Service Codes: Indicate where the service occurred (e.g., outpatient facility, hospital). 59 for distinct procedural service).

Medical Billing 59

Medical Billing Medical Billing Outsourcing Medical Billing Services Hospitals 59

Medisys Compliance

FEBRUARY 9, 2024

Providers should consult the latest CPT manual and coding resources to ensure they are using the correct codes for their services. Hospital Outpatient Prospective Payment System (OPPS) Updates OPPS is a payment system used by Medicare to reimburse hospitals for outpatient services, including some wound care procedures.

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Medical Billing Outsourcing Payment Systems Medical Billing Medicare 59

Healthcare IT Today

JUNE 29, 2023

Understanding ASCs Regulatory Changes and Their Billing Practices Outpatient surgery centers (ASCs) perform many surgical procedures outside of hospitals. However, ASC billing practices must be followed to ensure proper reimbursement and regulatory compliance. ASCs must also meet Medicare’s Conditions for Coverage.

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Compliance Medicare Medicare Medical Billing 52

Medisys Compliance

JUNE 16, 2022

Medicare’s 3-day (or 1-day) payment window applies to outpatient services that hospitals and hospital wholly owned or wholly operated Part B entities furnish to Medicare beneficiaries. Defining Diagnostic Services. Hospital subject to 1-Day Payment Window. Inpatient rehabilitation hospitals and units.

Medical Billing 52

Medical Billing Medical Billing Outsourcing Hospitals Medicare 52

Medisys Compliance

APRIL 20, 2022

We shared billing update for free COVID-19 tests and second free booster dose in detail in this article. Medicare to Cover Over-the-Counter COVID-19 Tests. People with Medicare can get up to eight tests per calendar month from participating pharmacies and health care providers for the duration of the COVID-19 public health emergency.

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COVID-19 COVID-19 Vaccine Medical Billing Medicare 52

Medisys Compliance

AUGUST 4, 2022

The Centers for Medicare & Medicaid Services (CMS) on June 21, 2022, issued a proposed rule that proposes to update payment rates and policies under the End-Stage Renal Disease (ESRD) Prospective Payment System (PPS) for renal dialysis services furnished to Medicare beneficiaries on or after January 1, 2023.

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Medical Billing Medical Billing Outsourcing Payment Systems Medicare 59

Medisys Compliance

APRIL 22, 2022

In the Medicare Physician Fee Schedule final rule issued in November 2021, the Centers for Medicare and Medicaid Services (CMS) added four new CPT codes (99424, 99425, 99426, and 99427) in the category of Principal Care Management (PCM) to replace the two previous PCM codes (HCPCS codes G2064 and G2065). PCM Codes Description.

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Medical Billing Medical Billing Outsourcing Medicare Medicare 52

Medisys Compliance

JUNE 28, 2022

Medicare Coverage for Continuous Glucose Monitors (CGMs). On December 28, 2021, the Centers for Medicare & Medicaid Services (CMS) published a final rule in the Federal Register that addressed the classification and payment of continuous glucose monitors (CGMs) under the Medicare Part B benefit for durable medical equipment (DME).

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Medical Billing Outsourcing Medical Billing Medicare Medicare 52

Medisys Compliance

JULY 18, 2022

In the Balanced Budget Act of 1997, Congress mandated that payment for the majority of services provided to beneficiaries in a Medicare covered SNF stay be included in a bundled prospective payment made through the Part A Medicare Administrative Contractor (MAC) to the SNF. This practice created several problems. To summarize.

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Medical Billing Medicare Medicare Medical Billing Outsourcing 52

Medisys Compliance

FEBRUARY 20, 2022

Note that, incident-to services are only applicable to Medicare. Incident-to services are only applicable for charges billed to a Medicare contractor. You will have to verify with each private insurance carrier on how to bill for services performed by an NPP.

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Medical Billing Outsourcing Medical Billing Medicare Medicare 52

Medisys Compliance

MARCH 10, 2022

For example, PCM could be appropriate for a patient with uncontrolled diabetes or uncontrolled hypertension or a high-risk patient with severe asthma who has frequent hospital readmissions. Many practices are already doing this work to take care of these patients, they just need to capture the right information so they can bill for it.

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Medical Billing Outsourcing Medical Billing Medicare Medicare 52

Medisys Compliance

AUGUST 8, 2022

In this article, we shared billing guidelines for anesthesia payment at personally performed rate and calculation of anesthesia time units. We referred Medicare billing guidelines from Medicare claims processing manual chapter 12.50 i.e., payment for anesthesiology services.

Medical Billing 52

Medical Billing Medical Billing Outsourcing Medicare Medicare 52

Medisys Compliance

FEBRUARY 5, 2024

Introduction The healthcare landscape is ever-evolving, and with it, the way medical services are delivered and billed. Ambulatory Surgery Centers (ASCs) have emerged as popular settings for various outpatient procedures, offering convenience and cost-effectiveness compared to traditional hospital stays.

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Medical Billing Outsourcing Medical Billing Medicaid Medicaid 59

Hall Render

APRIL 12, 2024

in billing fraud Arizona system names new CEO Banner Health CEO Peter Fine to retire after 24 years, handing the reins to health system president Four UArizona bioscience startups selected for Flinn Foundation program Gov. to Develop Wearable Blood Loss Detector An Academic Lifeline for Rural Hospitals CHI St.

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Nursing Homes Nurses Hospitals Medicaid 40

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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Medical Billing Medicaid Medicaid Telemedicine 52

Medisys Compliance

MAY 25, 2022

If your practice depends on a hospital or other facility to provide procedure or diagnosis data, make sure that the chargemaster and diagnosis listing contains the most current version of CPT, HCPCS, and ICD-10 codes. To know more about our complete medical billing services, contact us at info@medisysdata.com / 302-261-9187.

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Medical Billing Medical Billing Outsourcing Medical Billing Services Hospitals 52

Medisys Compliance

MARCH 26, 2024

Place of Service (POS) Codes POS 11: Outpatient office setting POS 21: Inpatient hospital setting Modifier Codes 51: Multiple procedures performed on the same day (e.g., Holter monitor application along with an EKG) 25: Unusual procedural service (e.g., complex Holter monitor placement due to patient anatomy) Global Codes vs.

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Medical Billing Outsourcing Medical Billing Governance Medical Billing Services 64

Medisys Compliance

MARCH 19, 2024

Additional Billing Considerations In addition to mastering the core billing codes, providers must also navigate supplementary elements integral to accurate billing: Place of Service (POS) Codes: Indicating the treatment setting (e.g.,

Medical Billing Outsourcing 59

Medical Billing Outsourcing Medical Billing Health Services Administration Public Health 59

Medisys Compliance

APRIL 7, 2023

Modifier 95 is recognized by Medicare and some other payers, but not all payers recognize this modifier. Modifier GT: Modifier GT is used to indicate that a service was provided via interactive audio and video telecommunication systems. We hope this article has answered the question how to bill mental health telehealth services.

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Medical Billing Medical Billing Outsourcing COVID-19 Medicare 52

Medisys Compliance

MARCH 28, 2022

American Hospital Association (AHA) recently conducted a survey on how providers are managing prior authorizations. AHA also reported 89 percent of hospitals and healthcare organizations have seen an increase in denials and 51 percent call this increase significant.

Medical Billing 52

Medical Billing Medical Billing Outsourcing Hospitals Medical Billing Services 52

Medisys Compliance

MARCH 21, 2024

Efficient billing practices play a vital role in achieving these goals. While Electronic Health Records (EHR) have become indispensable for patient management, OB/GYN practices often underutilize their full potential for billing. Introduction The ever-evolving healthcare landscape presents OB/GYN practices with continuous challenges.

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Medical Billing Outsourcing Medical Billing Doctors Medical Billing Services 59

Medisys Compliance

MARCH 25, 2022

According to hospital benchmarks, AR days for facilities can range between 30 and 70 days. Most experts agree that an average AR days measurement above 50 indicates a problem in medical billing or collection processes. (Total Receivables – Credit Balance)/Average Daily Gross Charge Amount (Gross charges/365 days). days in A/R.

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Medical Billing Medical Billing Outsourcing Medical Billing Services Hospitals 52