Log Into Your Account


Or Create an Account

MEDICAL BLOG

$636 Million in Overpayments Made by Medicare to Providers for Neurostimulators

Christine Woolstenhulme, QCC, QMCS, CPC, CMRS
2022-03-31

According to the OIG "MEDICARE OVERPAID MORE THAN $636 MILLION FOR NEUROSTIMULATOR IMPLANTATION SURGERIES." So often we think if we get paid, we must be doing it right, well this is not always the case. You may get paid and then have to return the funds if billed incorrectly or a step ...

Read More

Dentists; Treating Patients with a Medical Condition

Christine Woolstenhulme, QCC, QMCS, CPC, CMRS
2022-01-25

Understanding a patient's medical condition can have an impact on healing, as well as other problems. Of course, a dentist is not required to diagnose a medical condition such as diabetes.  However, it is in the patient's best interest that the provider is aware of any conditions that may affect ...

Read More

Treating the Genitofemoral Nerve?

Christine Woolstenhulme, QCC, QMCS, CPC, CMRS
2022-01-25

Finding which CPT code is appropriate for certain nerves can get complicated. Recently I was asked which CPT code would be used for radiofrequency ablation of the genitofemoral nerve and for a second procedure: release of psoas tendon under ultrasound guidance. Radiofrequency Ablation of the Genitofemoral Nerve I found is there is no code ...

Read More

Müller Muscle Conjunctival Resection Versus External Levator Advancement

Christine Woolstenhulme, QCC, QMCS, CPC, CMRS
2021-12-07

Read More

Understanding ASCs and APCs: Indicators and Place of Service

Christine Woolstenhulme, QCC, QMCS, CPC, CMRS
2021-10-28

The decision regarding the most appropriate care setting for a given surgical procedure is determined by the physician based on the patient's individual clinical needs and preferences. Of course, there is a difference in reimbursement, and the billing depends on where the procedure took place, such as an office setting, inpatient ...

Read More

Dental-Provider Specialty Taxonomy Codes

Christine Woolstenhulme, QCC, QMCS, CPC, CMRS
2021-10-06

The National Uniform Billing Guidelines require the use of taxonomy codes for claims submissions on the ADA-Dental claim form and the CMS-1500 Medical Claim form. When reporting the taxonomy code, be sure the provider is contracted with the payer under the taxonomy code being reported. We have listed the general ...

Read More

Injection Services

Christine Woolstenhulme, QCC, QMCS, CPC, CMRS
2021-09-29

Injection Service Codes Injection service codes, are reported under administration of vaccines/toxoids, using 96372, 90460, 90461, 90471, 90472, 0001A, 0002A, 0003A, 0011A, 0012A, 0021A, 0022A, 0031A, 0041A, and 0042A. Other injections services include: Non-antineoplastic hormonal therapy injections – 96372 Anti-neoplastic nonhormonal injection therapy 96401 Anti-neoplastic hormonal injection therapy- 96402 Allergen immunotherapy - 95115-95117 According to CMS, do ...

Read More

When is it Proper to Bill Nurse Visits using 99211

Christine Woolstenhulme, QCC, QMCS, CPC, CMRS
2021-09-28

When vaccines or injections are given in the office, coding can often get confusing; for example, is it correct to report a nurse visit using 99211 and an E/M office visit reporting 99202 ‑ 99215 and include injection fees with the vaccine product? In addition, the reporting of evaluation and management (E/M) during the same visit ...

Read More

Billing Dental Implants under Medical Coverage

Christine Woolstenhulme, QCC, QMCS, CPC, CMRS
2021-08-12

Implants can be costly to the patient and the provider, and it is crucial to understand how to bill a patient’s medical insurance to ensure there is adequate coverage for the best treatment. Implants are commonly billed in a dental office under a patient’s medical benefits.    Implants could be considered ...

Read More

Understanding How Place of Service Codes Work

Christine Woolstenhulme, QCC, QMCS, CPC, CMRS
2021-08-04

The Place of service (POS) codes are used by CMS, Medicaid, and other private insurance to indicate where medically related items and services are sold or dispensed for a patient. POS codes are used for professional billing and are required to be reported on each claim submitted on a CMS-1500 ...

Read More
Show All