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First, Humana DID pay 80%. It's 80% of the allowed amount, not 80% of billed charges. $763.96 x 80% = $611.17.
But here's the thing... unless it is in the deductible period at the beginning of the ... [ Read More ]
Any advice would be appreciated.
I have an example of a patient that has Humana Medicare Replacement as primary and Medicaid as secondary. Billed amount $2,150. Humana allowed $763.96 and paid $611.17... [ Read More ]
[B]Procedures:
INCISION AND DRAINAGE OF ABSCESS WITH REMOVAL OF FOREIGN BODY[/B]: The plantar surface of the right foot was cleansed with Betadine swab sticks ×3. No local anesthesia was used. Th... [ Read More ]
Per NCD 20.15 its not covered for routine other than the initial welcome to medicare visit.
[QUOTE][COLOR=#000000][FONT="]There is no coverage for EKG services when rendered as a screening test o... [ Read More ]
[QUOTE="elizabethcaste, post: 426935, member: 344648"]How do you code a patient that is coming for therapy services and dx is status post rt shoulder arthroplasty?[/QUOTE]
Didn't see any replies, so ... [ Read More ]
[QUOTE="Chelsea1, post: 410292, member: 166144"]I do not know which stent code to use for the following portion of this report;
Using a LIMA guiding catheter, the ostium of the LIMA graft was cannuli... [ Read More ]
A provider has asked the following question - There are different codes for follow-up paps when someone has had an abnormal one. There are the abnormal cytology ones R87.610, .611, .612, .613. Then th... [ Read More ]
A provider has asked the following question - There are different codes for follow-up paps when someone has had an abnormal one. There are the abnormal cytology ones R87.610, .611, .612, .613. Then th... [ Read More ]
[QUOTE="kseverson, post: 402961, member: 40199"]I am a certified coder. In my current job, I'm an office manager and do the coding along with all the other office management tasks. I'm thinking abou... [ Read More ]
AAPC member Susan Suwinski CPC CDEI CDEO CPB CPMA CRC CGSC CHONC has worked in healthcare for over 20 years in many industry settings including hospitals physician practices health plans skilled nursi... [ Read More ]
CMS bats down argument to correct inflation underestimation. The slight increase in hospices 2024 payment rates as compared to the amount proposed back in March isnt going to be enough to stave off ha... [ Read More ]
On the horizon Uber Health expands patient access to healthy food delivery and overthecounter items. On June 13 Uber Health announced Uber will soon deliver groceries and other overthecounter OTC item... [ Read More ]
Protecting your practice from revenue loss is easy when you have all the facts. In this everchanging world where more and more options are available for birth control its important that we stay abreas... [ Read More ]
You wont find these codes in your 2023 code books but they are effective April 1. The Centers for Medicare 38 Medicaid Services CMS has released coding changes and policy updates for the Outpatient Pr... [ Read More ]