Chronic pain is a significant health problem in the United States, affecting between 11 and 40 percent of adults. Pain management specialists are tasked with providing patient-centered care while navigating the complexities of insurance scrutiny, changing codes, prior authorization requirements, fee schedule cuts, and increased patient financial responsibility. Partnering with a medical coding company that […]
Nerve blocks are a challenging aspect of same-day surgery coding, and many coders find themselves unsure about when to code nerve blocks separately. This article aims to clarify the guidelines for coding nerve blocks in the context of anesthesia and pain management. What is a Nerve Block? A nerve block is the injection of numbing […]
As healthcare practices navigate the evolving landscape of Medicare policies, it is crucial to stay informed about significant updates. One such update pertains to the coverage of anesthesia and sedation during facet joint injections, impacting pain management physicians. Here’s a detailed breakdown of the recent changes and what they mean for your practice. Key Updates […]
Medicare’s Targeted Probe and Educate (TPE) audits are designed to identify and correct billing errors in a more “warm and fuzzy” manner compared to traditional audits. While the process might seem intimidating, understanding the TPE audit’s structure and requirements can help healthcare practices better prepare and respond. This comprehensive guide will break down the TPE […]
Payer agreements are contractual arrangements between healthcare providers and payers, ensuring that providers receive proper reimbursement for the care they provide to patients covered under specific payers. These contracts are essential for several reasons, benefiting providers, payers, and patients alike. Ensuring Timely Reimbursement One of the primary advantages of payer agreements is the assurance of […]
Denied claims are a common challenge in the healthcare industry, with one-third of all submitted claims being denied or ignored upon initial submission. While this might sound discouraging, it also means that 66% of your claim revenue is still being received. However, the financial impact of denied claims is substantial, with hospitals losing an average […]
In 2021, 60% of healthcare payments were tied to value and quality-based care, while 40% originated from fee-for-service models. These two systems are often viewed as polar opposites in the healthcare industry. While the adoption of value-based care is increasing, fee-for-service remains a significant component of the healthcare payment landscape. It’s crucial to understand both […]
The healthcare landscape is continuously evolving, with new legislation frequently impacting how medical practices operate. Among these, the No Surprises Act (NSA), introduced in January 2022, stands out due to its significant implications for all medical providers and facilities. Non-compliance can lead to penalties of up to $10,000, making it crucial for healthcare practices to […]
Discover the essentials of ICD-10 coding for neurological conditions such as headaches, migraines, narcolepsy, and hemiplegia. This guide provides detailed information and coding tips for healthcare practices to ensure accurate billing and efficient management of neurological cases. Headaches and Migraines: Understanding the Differences Headaches and migraines are common neurological complaints, yet they differ significantly in […]
The ICD-10 coding guidelines for nervous system disorders are essential for accurate medical coding and billing. This article aims to provide an overview of the key guidelines and considerations for coding nervous system conditions, specifically focusing on Chapter 6 of the ICD-10-CM, which covers diseases of the nervous system. Dominant and Non-Dominant Side in Coding […]
