by purush167 | Jan 29, 2022 | Medicare payment basics
New code COVID Vaccine Administration Codes 0001A – Immunization administration by intramuscular injection of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) (coronavirus disease [COVID-19]) vaccine, mRNA-LNP, spike protein, preservative free, 30 mcg/0.3...
by purush167 | Jan 10, 2022 | Medicare payment basics
Principal Care Management Services: 99424 – 99427 Principal Care Management new codes for Physicians or other qualified healthcare professionals The CPT Editorial Panel also created new codes for principal care management (99424, 99425, 99426, 99427), which allow...
by purush167 | Jan 5, 2022 | Medicare payment basics
What is Open Payments? Open Payments is a federally run transparency program that will increase public awareness of financial relationships between the health care industry and physicians by collecting and making public any payments or transfers of value between drug...
by purush167 | Dec 15, 2021 | Medicare payment basics
Employer Group Waiver Plans Benefits of an EGWP Once all EGWP subsidies are received, your organization could realize an additional annual cash savings of $500- $700 per Medicare-eligible retiree or covered dependent per year compared to RDS. If you are a plan sponsor...
by purush167 | Nov 23, 2021 | Medicare payment basics
IMPORTANT DEFINITIONS Plans Subject to COBRA Almost all employers with group health plans must comply with COBRA, including corporations, partnerships and tax-exempt organizations. There is a small employer exception to COBRA—an employer’s group health plan is not...
by purush167 | Oct 9, 2021 | Medicare payment basics
CPT Code Description 93880 Duplex scan of extracranial arteries; complete bilateral study Duplex scanning of arteries for the evaluation of blood flow is a type of non–invasive vascular diagnostic process. A physician can visualize and selectively assess the flow...
by purush167 | Aug 12, 2021 | Medicare payment basics
Incidental Procedures An incidental procedure is carried out at the same time as a more complex primary procedure. These procedures require little additional provider resources and are generally not considered necessary to the performance of the primary procedure. For...
by purush167 | Jul 10, 2021 | Medicare payment basics
Medicare Allowed Amount Definition Maximum amount on which payment is based for covered health care services. This may be called “eligible expense,” “payment allowance” or “negotiated rate.” If your provider charges more than the medicare allowed...
by Medical Billing | May 28, 2021 | Medicare payment basics
CPT CODE and Description30075-16 [977] Biopsy of pancreas30473-00 [1005] Panendoscopy to duodenum30688-00 [1949] Endoscopic ultrasoundDOUBLE BALLOON ENTEROSCOPYDouble balloon enteroscopy (DBE) is an endoscopic technique that allows examination of the small...
by Medical Billing | Mar 15, 2021 | Medicare payment basics
MODIFIER 22-UNUSUAL PROCEDURAL SERVICES This modifier indicates that a procedure was complicated, complex, difficult, or took significantly more time than usually required by the provider to complete the procedure. Documentation should be in simple “layman...