Physicians are increasingly fighting multiple forces in running a practice, and one of the most common barriers to effective revenue cycle management is frequent medical billing and claim denials. An insurance company’s denial for services places a significant strain on the financial process of the practice, which affects the bottom line. According to the Medical…
Take the Challenge. ICD-10 Codes R76.1—Raised antibody titer L20.8—Other atopic dermatitis R20.2—Paresthesia of skin R20.1—Hypoesthesia of skin CPT Codes 99358 and 99359 Rationale The Centers for Medicare & Medicaid Services (CMS) typically does not allow separate payment for physician services that do not require face-to-face time with a patient, but as of Jan. 1, 2017,…
Take the challenge. CPT codes: 99214-25, 20610-RT, J1030x1 Diagnoses: M05.79, M25.561 This is an established patient visit with an established diagnosis, along with a new diagnosis, which would have to be billed under the PA’s National Provider Number (NPI) and reimbursed at 85% of the fee schedule. Keep in mind that to qualify as an…
Selling a medical practice can be a lucrative endeavor. One of the most important phases of any sale transaction is the due diligence process. During this phase, a potential buyer and their advisors have the opportunity to examine the seller’s books, records and files in great detail to ensure that the buyer is comfortable purchasing…
The landscape of practice management and coding methodologies continues to be challenging in the current healthcare environment, and rheumatology practices must maintain focus on managing an effective and efficient practice. Join us at the 2017 ACR/ARHP Annual Meeting, Nov. 3–8 in San Diego, and gain knowledge and understanding of best practices in an ever-changing environment…
A 66-year-old woman returns to the office for a follow-up visit. She is seen by the physician assistant (PA) for her rheumatoid arthritis. She is experiencing burning pain in her right knee, and she reports that after going for her morning walk, she rates the pain at a 6 on a scale of 10. She…
A 66-year-old female patient returns to the office complaining of swelling and a burning pain in her right first toe. She rates the pain level at a 9 out of 10. She currently takes an over-the-counter non-steroidal anti-inflammatory drug (NSAID), but it has done little to alleviate the pain. This is her second episode this…
Take the challenge. CPT: 99214-25, 89060, 20600-RT ICD-10: M10.271, T50.2X5A, I10 This is an established outpatient visit. This encounter is coded as 99213, because it included: History—Detailed: The history of present illness is extended, the review of systems is extended, and the past medical and social histories are documented. Examination—Detailed: Seven organ systems are examined….
The levels of service within an evaluation and management (E/M) visit are based on the documentation of key components, which include history, physical examination and medical decision making. The history component is comparable to telling a story and should include a beginning and some form of development to adequately describe the patient’s presenting problem. To…
Take the challenge. CPT: 99213, 96413, 96415 x1, J1745 x 20* ICD-10: M05.09 This encounter is coded as 99213 because: History—The history of present illness is extended. The review of systems is detailed, and two of the three past, family, social history were documented, which makes the history level detailed. Exam—There are four systems examined,…