Billing in pain management is complex, requiring pain physicians to navigate unique coding challenges, payer requirements, and compliance standards. From proper documentation of single-use vials to understanding Evaluation and Management (E/M) code changes, staying informed on billing practices can directly impact a practice’s revenue and reduce risks of audits and penalties. Here are some critical […]
Infusion services are a critical revenue stream for many healthcare practices. By optimizing billing practices, practices have the opportunity to significantly boost their revenue. Even a slight improvement in reimbursement rates for each infusion can add up to substantial gains over time. Without proper attention to billing, practices may be missing out on additional revenue […]
Accurate medical coding is crucial for effective revenue cycle management (RCM) in healthcare practices, especially in the field of obstetrics and gynecology (OB/GYN). This article explores the specific ICD-10-CM coding guidelines for pregnancy-related conditions, providing valuable insights and best practices to enhance coding accuracy and efficiency. Understanding Chapter 15: Pregnancy, Childbirth, and the Puerperium Chapter […]
Billing for newborn office visits can be a complex process for healthcare practices, particularly when navigating the intricate rules of insurance carriers. Understanding the nuances of newborn billing, from initial coding to ensuring proper insurance enrollment, is crucial for minimizing denials and ensuring timely reimbursements. Coding for Newborn Office Visits When a newborn is discharged […]
Diabetes is a widespread diagnosis in the United States, with over 10% of the population affected by this condition. Given its prevalence, healthcare practices need to be well-versed in the coding guidelines for diabetes to ensure accurate documentation, proper patient care, and correct reimbursement. Types of Diabetes When coding for diabetes, the first thing to […]
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 […]
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 […]
