CPT Modifier 22 and 24

Modifier 22  The 22 modifier is used to identify an unusual procedural service. By using this modifier you are indicating that the procedure in question required a level of care greater than that usually required. When using this modifier medical records must be...

CPT modifiers – Assistan physician

Assistant at Surgery (CPT Modifiers 80 81 82 and AS)  We will continue to pay assistants at surgery at 16 percent of the surgical allowance, with the exception of Physician Assistants (PA) and Nurse Practitioners (NP), which are further reduced because these...

EDI – common question and guidelines

I Submitted an EDI Enrollment Form. When Can I Start Billing Electronically? Here are some important tips to keep in mind once you have submitted an EDI enrollment form: If you provide an e-mail address of your contact person on the EDI enrollment forms, Medicare EDI...

CMS 1500 billing instruction

We have listed the some common guidelines for printing CMS 1500. Do’s and Dont’s 1) Use original claim forms 2) Use block ink (not a black marker) 3) Print claim data within defined boxes on the claim form 4) Use all capital letters 5) Use a laser printer...

EDI Guidelines

What is EDI Here i have listed most and common errors in the EDI form when you filled up. So please have this remembered and fill up the form accordingly. Electronic Data Interchange (EDI) Providers can decrease paperwork and increase operating efficiency with...

Medicare eob reason codes

101    Predetermination: anticipated payment upon completion of services or claim adjudication. 102    Major Medical adjustment. (Not Medicare). 103    Provider promotional discount (i.e. Senior citizen discount). (Not...

Medicare denial reason codes

Medicare denial CO codes 51    These are non covered services because this is a pre-existing condition. 52    The referring/prescribing/rendering provider is not eligible to refer/prescribe/order/perform/the service billed....