MEDICAL BLOG

Incident To

Christine Woolstenhulme, QCC, QMCS, CPC, CMRS
2020-10-28

Just about any large clinic you visit will have non-physician practitioners, or NPPs. These will include physician assistants, nurse practitioners, and clinical nurses for example. Practices and clinics can bill under the NPPs if they are credentialed with the payer, but the reimbursement is only 85% of the fee schedule. There ...

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OIG – Fraud and Abuse Study with COVID-19 Testing

Christine Woolstenhulme, QCC, QMCS, CPC, CMRS
2020-10-27

According to the Office of Inspector General (OIG), “The coronavirus disease 2019 (COVID-19) pandemic has led to an unprecedented demand for diagnostic laboratory testing to determine whether an individual has the virus. Beyond the COVID-19 tests, laboratories can also perform add-on tests, for example, to confirm or rule out diagnoses ...

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My Location and CBSA is Missing!

Christine Woolstenhulme, QCC, QMCS, CPC, CMRS
2020-09-23

We often get questions on missing Core Based Statistical Areas, known as CBSAs. CBSAs are used for pricing and other factors according to the geographical location. If you do not see your CBSA, it is important to note they are not missing - it may not have an assignment, according to ...

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More COVID-19 Codes Added as of September 8, 2020

Wyn Staheli, Director of Research
2020-09-15

The American Medical Association (AMA) recently announced the addition of two more CPT codes in relation to COVID and the Public Health Emergency (PHE). Codes 99702 and 86413 were posted to the AMA website on Tuesday, September 8, 2020 and new guidelines have been added as well.

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Not Following the Rules Costs Chiropractor $5 Million

Wyn Staheli, Director of Research
2020-09-01

Every healthcare office needs to know and understand the rules that apply to billing services and supplies. What lessons can we learn from the mistakes of others? What if we have made the same mistake?

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New Value-Based Payment Models for Primary Care (Primary Care First and Direct Contracting)

Jared Staheli
2020-08-28

This article summarizes the new Medicare value-based payment models: Primary Care First and Direct Contracting.

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Podcast - Do you have all the right Dental resources needed to succeed in Dental Medical Billing and Coding?

Innoventrum
2020-08-27

Discussion between innoviHealth CEO, LaMont Leavitt and Guest speaker, Christine Taxin who is an Adjunct professor at New York University, and President of Dental Medical Billing and Links2Success about making sure you have all the right Dental resources needed to succeed in Dental Medical Billing and Coding. ...

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Is COVID-19 Causing Risk Adjustment “Gotcha’s”?

Wyn Staheli, Director of Research
2020-08-27

The COVID-19 public health emergency (PHE) has created some possible problems when it comes to risk adjustment. Be sure your organization has implemented policies and procedures to try and overcome these new hurdles.

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New and Exciting Changes in the Dental Industry

Christine Taxin - Links 2 Success
2020-08-26

My colleagues and I are nerds for information on all things billable—or not billable—in the worlds of dental and medical insurance. One of the most puzzling challenges for me over the past 15 years of teaching has been to understand why we on the dental side are segregated out of ...

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Coding Injections for Pain Management

Christine Woolstenhulme, QCC, QMCS, CPC, CMRS
2020-08-10

Coding for pain management can get confusing. How many injections, the location, and when to use a modifier are all common questions. This article will cover some of the most common injections used in pain management. Trigger Point Injections Trigger point injections are reported by how many muscles are treated using an ...

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