Apr 1, 2011 | Medical billing basics
Medicare covers surgical co-management for appropriate reasons such as inability of the operating surgeon to provide postoperative care, inability of the patient to return to see the operating surgeon in the postoperative period for a variety of reasons or patient...
Apr 1, 2011 | Medical billing basics
AFFECTED CPTs – J7613, J7626,J2405, J0696 DESCRIPTION OF THE ISSUEMedicaid and MCD HMOs denied all injection codes for need of NDC# update. CONCEPTAll injection drug codes should be billed along with NDC# updates for the claims to be reimbursed. REASONCompiled...
Mar 30, 2011 | Medical billing basics
FREQUENTLY ASKED QUESTIONS Question: What is the difference between the GP and GY modifiers? Do we use GP, GY and GA for physical therapy charges? Answer: Yes, it is possible that physical therapy services could be billed with all three modifiers. (Remember that the...
Mar 29, 2011 | Medical billing basics
REASONS FOR DENIAL * When the number of manipulations exceeds the norm. (This type of denial will still require a claim be submitted to Medicare.) * Excluded Services: An excluded service from Medicare coverage is any service other than manual manipulation for...
Mar 28, 2011 | Medical billing basics
CHIROPRACTORS BILLING FOR PHYSICAL THERAPY Chiropractors billing for physical therapy services (CPT codes 97001–97799 and HCPCS code G0283) must bill with the appropriate modifier. * GN – Services delivered under an outpatient speech-language pathology plan of care. *...
Mar 27, 2011 | Medical billing basics
Medicare X RAY coverage As of January 1, 2000, an x-ray is not required by Medicare to demonstrate the subluxation. However, an x-ray may be used for this purpose if you so choose. The x-ray must have been taken reasonably close to (within 12 months prior or 3 months...
