2017 New CPT Codes for Billing Coding Presumptive Drug Class Procedures, UDS, Urinary Drug Screening and Immunoassay | Point of Care UDT
Jan29

2017 New CPT Codes for Billing Coding Presumptive Drug Class Procedures, UDS, Urinary Drug Screening and Immunoassay | Point of Care UDT

Wow! we have new codes effective January 1, 2017 for Presumptive Screening Toxicology CPT codes. These will replace both the AMA CPT and Medicare’s HCPCS for presumptive drug testing. The following AMA CPT codes for presumptive urine drug testing are now DELETED and no longer recognized effective January 1st 2017 80300 – Drug screen, any number of drug classes from Drug Class List A; any number of non-TLC devices or procedures (e.g., immunoassay) capable of being read by direct optical observation, including instrumented-assisted when performed (e.g.. Dipsticks, cups, cards, cartridges) per date of service **** ONLY report once, regardless of the number of drug class per date of service 80301 – single drug class methods, by instrumented test systems (e.g. Discrete multichannel chemistry analyzers utilizing immunoassay or 2 enzyme assay), per date of service **** Report ONLY once for a single or multiple procedures performed, regardless of the number of performed, classes or results on any date of service 80302 – Drug screen, presumptive, single drug class from Drug Class List B, by immunoassay (e.g. ELISA) or non-TLC chromatography without mass spectrometry (e.g. GC, HPLC), each procedure **** Report each drug class once per date of service 80303 – Drug screen, any number of drug classes, presumptive, single or multiple drug class method; thin layer chromatography procedure(s) (TLC) (e.g. Acid, neutral, alkaloid plat), per date of service **** Report single or multiple drug procedures, once per day of service 80304 – not otherwise specified presumptive procedure (e.g. TOF, MALDI, LDTD, DESI, DART), each procedure **** Report single or multiple drug screenings, per testing site, per date of service, per each procedure DELETED HCPCS G-Codes for Urine Drug Screening for 2017 G0477 Drug tests(s), presumptive, any number of drug classes; any number of devices or procedures, (eg immunoassay) capable of being read by direct optical observation only (eg, dipsticks, cups, cards, cartridges), includes sample validation when performed, per date of service. G0478 Drug tests(s), presumptive, any number of drug classes; any number of devices or procedures, (eg immunoassay) read by instrument-assisted direct optical observation (eg, dipsticks, cups, cards, cartridges), includes sample validation when performed, per date of service. G0479 Drug tests(s), presumptive, any number of drug classes; any number of devices or procedures by instrumented chemistry analyzers (eg, immunoassay, enzyme assay, TOF, MALDI, LDTD, DESI, DART, GHPC, GC mass spectrometry), includes sample validation when performed, per date of service. Your 2017 Presumptive Urine Drug Testing CPT Codes TAKE NOTE:  CMS will recognize the new 2017 AMA published drug testing CPT codes 80305, 80306 and 80307 as replacement codes for HCPCS codes G0477, G0478 and G0479. CPT codes 80305, 80306 and 80307 will...

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How much is Allowed During the Global Period Using Modifier 58, 78 and 79
Jan17

How much is Allowed During the Global Period Using Modifier 58, 78 and 79

How much is Allowed During the Global Period Using Modifiers 58, 78 and 79 These 3 Modifiers are commonly used when the service was rendered during the Surgical Global Period. And you might be wondering how are they being reimbursed based on the allowable amount? Well, here’s what I thought I should be sharing to you. Modifier 58  What it indicates, “staged or related procedure or service by the same physician during the post-operative period.” when; planned at the time of the original procedure, or staged; it is more extensive than the original procedure; or a therapy following a diagnostic surgical procedure. *** DO NOT use Modifier 58 if the Procedure is Converted from Laparoscopic to Open Procedure Reimbursement: 100% of the allowable amount Modifier 78  What it indicates,  “unplanned return to the operating/procedure room by the same physician following initial procedure for a related procedure during the post-operative period. When this procedure is related to the first and requires the use of an operating or procedure room, it may be reported by adding modifier 78 to the related procedure.” Reimbursement: Likely up to 80% of the allowable amount; why? well, its because it is related to the procedure that is within the global period. Modifier 79  What it indicates, “unrelated procedure or service by the same physician during the post-operative period.” Reimbursement: 100% of the allowable amount Need Immediate Help?  CHAT WITH US/TEXT/CALL  (888) 822-0862 Email: pinky.maniri@gmail.com  We Offer CONSULTING SERVICES  We always OVER-DELIVER! 100% Satisfaction Guaranteed. Or we will return your money! We offer hourly coding consulting time on certain specialty only: Pain Management General Surgery Anesthesiology Physical Medicine and Rehabilitation Dermatology Obesity Medicine Sports Medicine Neurology Spine and Orthopedic Surgery Physical Therapy / Occupational Therapy / Speech Pathology Chiropractic Services Workers Comp and Motor Vehicle Accident Cases Medical Billing, Coding, Reimbursement and E/M Questions? We can help you navigate your practice on how to INCREASE REVENUE by looking at additional Services that you can possibly do in your Practice based on your Specialty. Other Services We Offer: Setting up a Medical Practice Revenue Cycle/Reimbursement Management Insurance Credentialing and Contract NegotiationsMedicare Enrollment and Credentialing Chart Auditing Staff Training Compliance Program Find this article useful? Please comment below and share what you just found from this website! Go ahead - please click "SHARE"EmailTweetShare on...

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2017 Deleted Epidural Pain Management Billing Codes 62310, 62311, 62318, 62319
Jan12

2017 Deleted Epidural Pain Management Billing Codes 62310, 62311, 62318, 62319

DELETED EPIDURAL CODES Effective January 1, 2017 and are REPLACED! 62310 Injection(s), of diagnostic or therapeutic substance(s) (including anesthetic, antispasmodic, opioid, steroid, other solution), not including neurolytic substances, including needle or catheter placement, includes contrast for localization when performed, epidural or subarachnoid; cervical or thoracic 62311 Injection(s), of diagnostic or therapeutic substance(s) (including anesthetic, antispasmodic,… Please LOGIN HERE to view this content. Or, REGISTER HERE Find this article useful? Please comment below and share what you just found from this website! Go ahead - please click "SHARE"EmailTweetShare on...

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2017 Epidural New Codes for Pain Management Practice – it’s in the Imaging
Jan12

2017 Epidural New Codes for Pain Management Practice – it’s in the Imaging

2017 Epidural New Codes for Pain Management Practice Effective January 1st 2017 your Epidural Pain Management Billing Codes 62310, 62311, 62318, 62319 have been DELETED! Here are our new codes for 2017 Epidural New Codes for Pain Management Practice! Keypoint – it’s in the imaging!! 62320 Injection(s), of diagnostic or therapeutic substance(s) (eg, anesthetic, antispasmodic, opioid, steroid, other solution), not including neurolytic substances, including needle or catheter placement, interlaminar epidural or subarachnoid, cervical or thoracic; without imaging guidance 62321 Injection(s), of diagnostic or therapeutic substance(s) (eg, anesthetic, antispasmodic, opioid, steroid, other solution), not including neurolytic substances, including needle or catheter placement, interlaminar epidural or subarachnoid, cervical or thoracic; with imaging guidance (ie, fluoroscopy or CT) 62322 Injection(s), of diagnostic or therapeutic substance(s) (eg, anesthetic, antispasmodic, opioid, steroid, other solution), not including neurolytic substances, including needle or catheter placement, interlaminar epidural or subarachnoid, lumbar or sacral (caudal); without imaging guidance 62323 Injection(s), of diagnostic or therapeutic substance(s) (eg, anesthetic, antispasmodic,opioid, steroid, other solution), not including neurolytic substances, including needle or catheter placement, interlaminar epidural or subarachnoid, lumbar or sacral (caudal); with imaging guidance (ie, fluoroscopy or CT) 62324 Injection(s), including indwelling catheter placement, continuous infusion or intermittent bolus, of diagnostic or therapeutic substance(s) (eg, anesthetic, antispasmodic, opioid, steroid, other solution), not including neurolytic substances, interlaminar epidural or subarachnoid, cervical or thoracic; without imaging guidance 62325 Injection(s), including indwelling catheter placement, continuous infusion or intermittent bolus, of diagnostic or therapeutic substance(s) (eg, anesthetic, antispasmodic, opioid, steroid, other solution), not including neurolytic substances, interlaminar epidural or subarachnoid, cervical or thoracic; with imaging guidance (ie, fluoroscopy or CT) 62326 Injection(s), including indwelling catheter placement, continuous infusion or intermittent bolus, of diagnostic or therapeutic substance(s) (eg, anesthetic, antispasmodic, opioid, steroid, other solution), not including neurolytic substances, interlaminar epidural or subarachnoid, lumbar or sacral (caudal); without imaging guidance 62327 Injection(s), including indwelling catheter placement, continuous infusion or intermittent bolus, of diagnostic or therapeutic substance(s) (eg, anesthetic, antispasmodic, opioid, steroid, other solution), not including neurolytic substances, interlaminar epidural or subarachnoid, lumbar or sacral (caudal); with imaging guidance (ie, fluoroscopy or CT)   Need Immediate Help?  CHAT WITH US/TEXT/CALL  (888) 822-0862 Email: pinky.maniri@gmail.com We Offer CONSULTING SERVICES and REVENUE/REIMBURSEMENT CYCLE MANAGEMENT We always OVER-DELIVER! 100% Satisfaction Guaranteed. Or we will return your money! We offer hourly coding consulting time on certain specialty only: Pain Management General Surgery Anesthesiology Physical Medicine and Rehabilitation Dermatology Obesity Medicine Sports Medicine Neurology Spine and Orthopedic Surgery Physical Therapy / Occupational Therapy / Speech Pathology Chiropractic Services Workers Comp and Motor Vehicle Accident Cases Medical Billing, Coding, Reimbursement and E/M Questions? We can help you navigate your practice on how to INCREASE REVENUE by looking...

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Why Physicians Medical Practice Cannot Make More Money
Jan09

Why Physicians Medical Practice Cannot Make More Money

Here are the 7 Common Reasons that I know make sense why many physicians cannot make more money! 1. Reimbursements are NOT being Maximized due to Poor Medical Coding Knowledge, Skill and Analysis Let me show you some example: a. Bilateral Procedure billed anatomically at only “one side” b. Surgery Converted to Open Procedure (the OP report documents from “Lap” to “Open” was performed) – how will you bill and code for this encounter? You may not know this, you cannot bill for both lap and open (check your CCI Edits!) together. And the guideline says, you have to report “Open” on your claim upon submission. c. Unbundling/bundling services that are billable based on the “Edits” and medical necessity d. No knowledge on how to utilize and use Modifiers e. Too naive that payments processed at 100% of the charged amount (“allowed amount”) is NOT GOOD! – it would’ve allowed more! 2. Out of Network Physician Services Payments can be a Big Challenge! Non-contracted physicians can be very challenging. Especially when they send the payments directly to their member / the patient! Any one experienced this? That’s why it is very important  that you make your patient sign a re-assignment of benefits so you get paid directly by the insurance company! You don’t have to accept assignment. 3. Lack of Effective Collection Techniques and Staff Training a. Copay is always due at the time of service – do many physicians do collect copay upfront? b. How often are patient statements being sent out? c. … there’s a lot more to site! 4. Now, isn’t it Time to Negotiate Fees and Update the Fee Schedule? When was the last time or have you ever thought of renegotiating your contracted fees? Wouldn’t it be time to analyze and review your contracts? Maybe its time to renegotiate your fees. 5. Missing “Revenue-Making” Opportunity for Additional Services in the Practice One good example, they know they can make big profit-margin on medically coded LSO Back Braces. And yet, they hesitate to even look at it. The truth is, it is always based on Medical Necessity! and Real-Time-Accurate Documentation, Period. You have to know your guidelines, policies and limitations. They are all out there, well documented. For instance, as a Physician, you are exempted to the Accreditation Process and Surety Bond – as long as you ONLY provide the LSO braces to your own patients as part of your services. READ HERE http://justmypassion.com/Who-are-Exempted-from-DME-POS-from-Accreditation-and-Surety-Bond-Application.html 6. Low Productivity is also one of the Reasons! a. Physician Services b. Accounts Receivables Collection 7. Too Much Cost Running the Practice a. Staffing b. Technology c. Supplies d. Lease There you...

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