[Important Update: In January 2015, CMS changed the -59 modifier to 4 more specific x codes. We updated this popular PYP post with more details below.]
Some billers do not really understand modifiers or when they need to use them. Add modifiers to CPT codes when they are required to more accurately describe a medical procedure or service.
A modifier should never be used just to get higher reimbursement or to get paid for a procedure that will otherwise be bundled with another code.
Each medical specialty comes with a unique set of challenges, and family medicine is no exception. Family physicians can overcome many of these clinical, financial and operational challenges using effective software solutions.
In this update, PYP takes a look at the state of this specialty, and what family physicians should consider in their health IT decision-making.
When it comes to patient collections, many practices think: the more aggressive, the better. Patients need to know that you mean business. The thing is, if you use threatening language, you also run the risk of putting people off.
Of course, not wanting to offend your patients shouldn’t stop you from doing everything you can to collect on delinquent accounts. You just need to approach the situation carefully so you don’t damage the relationships you work so hard to set up and maintain. After all, your practice needs to keep patients to stay in business.
Power Your Practice continues to focus on the state of certain medical specialties and on the best software functionality for practice management and EHR systems.
Each medical specialty needs different software capabilities to meet distinct clinical, financial and operation challenges — and neurology is no exception.
The imminent transition from ICD-9 to ICD-10 tends to generate strong opinions. When the Centers for Medicare & Medicaid Services delayed ICD-10 implementation to October 1, 2015, some viewed it as a positive while others saw the move as a negative.
No matter what your opinion, there’s no denying ICD-10 will usher in more diagnosis codes than ICD-9. CMS estimates about 68,000 ICD-10 codes will go into effect October 1, 2015 (compared to about 13,000 ICD-9 diagnosis codes in use today).
It’s not just the greater number of codes — ICD-10 increases specificity in most instances, and with that comes greater complexity. This means some specialties could experience a more difficult transition than others. Cardiology, nephrology and neurology, for example, could face drastic changes to some of their most common codes.
Claims denied for timely filing remain a major challenge for medical billers. Each insurance carrier follows their own guidelines on what constitutes filing claims in a timely fashion.
Some insurers require claim submissions within 30 days and others allow up to two years. To cut your chances for these claim denials, follow their guidelines.