Telehealth Claim Denial

Claim Denial Telehealth: Check 2 Items Before Refiling

QUESTION: We just received our first denial for a telehealth service using audio-visual. The claim was filed with office visit code 99212, place of service 02 for telehealth and modifier 95. Can you tell us what we did wrong so that we can get paid for these visits? Question from Palatine, Illinois Subscriber ANSWER: Based […]
RTM codes

Boost Payup, Improve Patient Care with 2022 RTM Codes

You can now get paid more for using digital health technology with your patients. As of January 1st, new codes for Remote Therapeutic Monitoring (RTM) allow you to get reimbursed for monitoring non-physiologic data. These codes opened up more patient care options, allowing your practice to use newer technology and still get reimbursed for it. […]
Unvaccinated patients

New ICD-10-CM Codes for Partially & Unvaccinated Patients

You’ll soon have new ICD-10-CM Z codes to report when treating patients who are partially vaccinated or unvaccinated for COVID-19. Unvaccinated patients. This new code set, effective April 1, 2022, includes four additions under Chapter 21 (Factors influencing health status and contact with health services). The codes were added to better track those who aren’t […]
Coding for COVID-19 Vaccines

Improve Accuracy & Boost Pay-up with New COVID Vaccine Codes

The American Medical Association (AMA) recently issued 11 new Current Procedural Terminology (CPT) codes to help make your coding for COVID-19 vaccines more accurate – and hopefully improve your reimbursement. So if your practice is administering vaccines under the Centers for Disease Control and Prevention’s (CDC) COVID-19 Vaccination Program — the only way to legally […]
2021 prolonged service changes

CPT Code 99417 Reimbursement Update: Get $20 for New 2021 Prolonged Service Changes

Update Notice: 2021 prolonged service changes. Important: This information was updated for accuracy on April 28th, 2021. The guidelines for counting total time for CPT code 99417 were revised to bring clarity around what can be included regarding patient education during a patient visit. You’ll find this update in the “Add Direct Plus Certain Indirect […]

Get Paid for 60 New Telehealth Codes in 2021

After a year of constant updates, the rule changes for telehealth coding have “finally” been finalized in the 2021 Physician Fee Schedule final rule. Keep reading to ensure you’re getting paid for every service—including the newly reimbursable telehealth codes. CMS Adds Services to Telehealth List. Beginning January 1, 2021, the list of services reimbursable when […]
COVID Vaccine Admininstration Coding

Get the Correct COVID-19 Vaccine Administration Code and Pay

You MUST use a totally different system to get paid and code for COVID-19 vaccine administration; unlike other vaccines that use generic administration CPT codes, coronavirus vaccine reporting requires unique codes. Get up to speed now on the available vaccines and how to report them correctly from your very first claim without over billing. There […]
2021 CPT Coding Changes

CPT 2021: Ace Your Lab, Debridement, and Diabetes Coding Changes

You’ve got to implement the 300 plus CPT 2021 coding changes by January 1, 2021, or you’ll face emotional and financial losses. Save yourself hours of chasing denials and payments by getting up to speed now on the new, revised, and deleted codes for drugs, ortho, diabetes and more. For help on the massive E/​M […]
Shoulder unbundling errors

Head Off Revenue Losses Due to Shoulder Unbundling Errors

You don’t want to miss billing an allowed shoulder procedure and leave thousands of dollars on the table. But it’s imperative that you avoid shoulder unbundling errors – or your repeated billing of included charges can land you with costly denials, and accusations of abuse or fraud. It’s critical that you know when to legally […]
CPT Code 99072 COVID PPE

Get Paid for Coronavirus Prevention – New Code Notification

Your cry that COVID-19 is costing you time and money has been heard. Now, you could be compensated for the extra expense that your practice spends on creating a safe environment for your patients and staff. Recently, the AMA created new CPT code 99072 to reimburse you under these circumstances. Below, find out exactly how […]