Medical Billing and Coding Resources
Medical Billing and Coding Resources
Millions of claims were denied because eligibility had expired or the patient or service was not covered by the plan. Maintaining a consistent and accurate verification process is essential to maintaining a healthy revenue cycle. Physicians need to verify each patient’s eligibility and benefits to ensure they will receive payment for services rendered. Insurance should […]
CO18 Denial Code: Duplicate Claim/Service Duplicate denials continue to be one of the top billing errors. It can be both counter-productive and costly for your practice, not to mention, they can end up getting you into trouble. Too many errors can result in the imposition of program integrity actions by the Medicare administrative contractor against […]
Claim Denial Denial of a claim is the refusal of an insurance company or carrier to honor a request by an individual, or his or her provider, to pay for health care services obtained from a health care professional. Many practices do not make the effort to appeal denied claims. As per AMA, the most […]
Split Surgical Care There are occasions when more than one physician may furnish aspects of the services included in the global surgical package. When different physicians of a group practice participate in the care of the surgical patient, the group practice bills for the entire global surgical package. The physician who performs the surgery is […]
Split Surgical Care There are occasions when more than one physician may furnish aspects of the services included in the global surgical package. When different physicians of a group practice participate in the care of the surgical patient, the group practice bills for the entire global surgical package. The physician who performs the surgery is […]
Split Surgical Care There are occasions when more than one physician may furnish aspects of the services included in the global surgical package. When different physicians of a group practice participate in the care of the surgical patient, the group practice bills for the entire global surgical package. The physician who performs the surgery is […]
Assistant at Surgery An ‘assistant at surgery’ is a physician/non-physician practitioner (NPP) who actively assists the physician in performing a surgical procedure. The ‘assistant at surgery’ provides more than just ancillary services. Documentation for an assistant at surgery services includes helpful information to assist providers inappropriately documenting medical necessity for assistant-at-surgery services. Now let’s look […]
Modifier AS: Non-physician Assisting at Surgery Medicare has established the AS modifier to report Physician Assistant (PA), Nurse Practitioner (NP), or Clinical Nurse Specialist (CNS) services for assistant-at-surgery, non-team member. Therefore, for Medicare reporting purposes and as directed by a commercial third-party payor, to indicate PA, NP, or CNS services for assistant-at-surgery, ‘AS’ would be […]
Modifier 82: Assistant Surgeon (when qualified resident surgeon not available) In certain programs or facilities (e.g., in teaching hospitals), the physician who generally acts as the assistant surgeon is a qualified resident surgeon. There may be times when a qualified resident surgeon is not available to assist the operating surgeon, so a physician assists the […]
Modifier 81: Minimum Assistant Surgeon Although a primary operating physician may plan to perform a surgical procedure alone, during the operation circumstances can arise requiring the services of an assistant surgeon for a relatively short time. In this instance, the second surgeon provides minimal assistance, for which he or she reports the surgical procedure code […]
