In Billing
Mar 20th, 2019
There is a lot of excitement about a new drug for women suffering from postpartum depression, but Sage Therapeutics’ Zulresso will present challenges for medical coders, their employers, and patients. First Postpartum Depression Drug Zulresso is the first drug developed specifically for postpartum depression. Often un- or misdiagnosed, postpartum depression (F33.0), affects an estimated natio...
In Billing
Mar 1st, 2018
Anthem has sent a letter to the AMA to announce  they are rescinding the policy reducing payment for physicians when billing an E/M with a modifier 25 and a procedure that has zero or 10 global days. Anthem was planning on taking a 25 percent reduction on all 25 modified services billed with minor procedures as ...
May 1st, 2012
Understand your use of CPT® codes prone to audit review. By Stacy Harper, JD, MHSA, CPC In the current regulatory environment, physicians are searching for ways to minimize audit exposure. Medicare administrative contractors (MACs) frequently review high-level evaluation and management (E/M) services. Review may be based on a random sample, or targeted based on provider ...
Apr 1st, 2012
2012’s bundling of procedures and assigning of “experimental” T codes can hamper provider reimbursement. By Barbara Cataletto, MBA, CPC Changes to CPT® 2012 spinal codes and coding guidelines have an important impact on reimbursement, new technologies, and the advancement of patient care. Let’s review the changes you’ll need to know to properly document and code ...