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Articles, tagged with "medical necessity", page 1

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Medicare Reimbursement: Modifiers KX, EY keys to DME Reimbursement

23rd June 2011
Providing refractive lenses for cataract surgery patients is it? Well, you will need to unravel your DME MAC's complex coding and billing rules to get yourself your deserved Medicare reimbursement. Test: Often ophthalmology coders describe durable medic... Read >
Author: James Smith

Modifiers KX, EY Vital for DME Reimbursement

07th June 2011
vProviding refractive lenses for cataract surgery patients? Well, you will need to unravel your DME MAC's complex coding and billing rules to get your deserved Medicare reimbursement. Many a time optometrists describe durable medical equipment (DME) codi... Read >
Author: James Smith

92225: How Do You Determine Medical Necessity For Billing Twice?

14th March 2011
Can you shed some light on billing 92225 or 92226 with modifier 50, RT/LT, or two units for a patient following a pseudotumor cerebri in a nursing home? How do you find out medical necessity for billing twice? Both 92225 (ophthalmoscopy, extended, with ... Read >
Author: Erin Lang Masercola

Do You Need To Add a Modifier To One Of The Codes?

01st March 2011
Our center provides DXA screenings to some cancer patients. We have been getting denials from Medicare on those claims where we code both 77080 and 77081. Is it required to add a modifier to one of the codes? Well, it all depends on your payer whether y... Read >
Author: James Smith

CPC-H practice exams will help you know how you’ll fare

07th January 2010
Today, health care is complex and requires expertise in proper coding payment for procedures, services, equipment and supplies provided to patients. A CPC-H is someone who has achieved a measurable level of knowledge and expertise in coding of services, p... Read >
Author: Celena

CPT Medical Coding Guidelines for Critical Care

15th April 2009
CPT medical coding or Current Procedural Terminology is the explanation of a procedure or service, identified with a five-digit code and descriptor nomenclature. The five-digit code and the descriptor explain the clinical procedures that were performed by... Read >
Author: Celena

Compensation Plan for Primary Care and Specialty Physicians

01st December 2008
Introduction: Sixty-four percent of large medical groups are owned by physicians, of which physicians are employees or employee-owners. 62% of medical groups are for profit. In fully competitive market, firms want to survive by either making profit thr... Read >
Author: Dr. Golam Md. Munir
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