Jul 6, 2017 | Medical billing basics
Claim Determinations When BCBSTX receives a properly submitted claim, it has authority and discretion under the Plan to interpret and determine benefits in accordance with the Plan provisions. BCBSTX will render an initial decision to pay or deny a claim within 30...
Jun 14, 2017 | Medical billing basics
Procedure Code Description 88305 Level IV surgical pathology, gross and microscopic examination…prostate needle biopsy… 88307 (Level V -surgical pathology, gross and microscopic examination) G0416 Surgical pathology, gross and microscopic examinations, for prostate...
May 26, 2017 | Medical billing basics
15570* Formation of direct or tubed pedicle, with or without transfer; trunk 15731* Forehead flap with preservation of vascular pedicle (e.g., axial pattern flap, paramedian forehead flap) 15732* Muscle, myocutaneous, or fasciocutaneous flap; head and neck (e.g.,...
May 24, 2017 | Medical billing basics
CPT Code Description 23470 Arthroplasty, glenohumeral joint; hemiarthroplasty 23472 Arthroplasty, glenohumeral joint; total shoulder (glenoid and proximal humeral replacement [e.g., total shoulder]) 23473 Revision of total shoulder arthroplasty, including allograft...
May 5, 2017 | Medical billing basics
Procedure code and Description 99251 Inpatient consultation for a new or established patient, which requires these 3 key components: A problem focused history; A problem focused examination; and Straightforward medical decision making. Counseling and/or coordination...
Apr 26, 2017 | Medical billing basics
• G0502: Initial psychiatric collaborative care management, first 70 minutes in the first calendar month of behavioral health care manager activities, in consultation with a psychiatric consultant, and directed by the treating physician or other qualified health...
Apr 25, 2017 | Medical billing basics
Q: My patient enrolled in a Medicare Advantage (MA) plan during the middle of the inpatient hospital stay. Who should I bill? A: When a patient enrolls or disenrolls in a MA plan during his/her inpatient stay, the following factors will determine whether to bill the...
Apr 21, 2017 | Medical billing basics
Generally speaking, when we say ‘objective measures,’ what does that mean? Answer: Objective measures consist of standardized patient assessment instruments, outcome measurements tools or measurable assessments of functional outcome. Use of objective...
Apr 4, 2017 | Medical billing basics
Allergic rhinitis due to pollen J30.1 is a billable/specific ICD-10-CM code that can be used to indicate a diagnosis for reimbursement purposes. This is the American ICD-10-CM version of J30.1. Other international versions of ICD-10 J30.1 may differ....
Mar 28, 2017 | Medical billing basics
ICD10 code for Vitamin D deficiency E20.0 Idiopathic hypoparathyroidism E20.8 Other hypoparathyroidism E20.9 Hypoparathyroidism, unspecified E21.0 -E21.3 Hyperparathyroidism and other disorders of parathyroid gland (code range) E55.0 Rickets, active E55.9...
