Whether in a hospital lab, reference laboratory, or physician office setting, if you’re involved in toxicology testing, you’re well aware that few areas of laboratory medicine face more reimbursement challenges. In 2025, toxicology testing continues to operate in an environment of intense scrutiny, evolving regulations, and shifting payer policies. With strategic knowledge of Current Procedural […]
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Behavioral health professionals continue to face a complex and evolving landscape of reimbursement challenges. The good news? Strategic knowledge of Current Procedural Terminology (CPT) codes can significantly boost your practice’s financial health while ensuring you’re fairly compensated for the valuable services you provide. Figuring out the nuances of behavioral health coding is no longer optional, […]
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The American Medical Association (AMA) announced today the release of the Current Procedural Terminology (CPT®) code set for 2025, marking a significant evolution in medical coding that reflects the healthcare industry’s rapid technological advancement and changing clinical practices. The updated code set, which serves as the foundation for medical billing and documentation across the United […]
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Medical billing codes are the backbone of healthcare administration worldwide, serving as a standardized way to communicate diagnoses, procedures, and treatments between healthcare providers, insurers, and government agencies. However, the question of whether these codes are truly universal is complex and multifaceted. We dissect the various medical coding systems used globally, their similarities and differences, […]
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Current Procedural Terminology (CPT®) codes are the backbone of medical billing in the United States healthcare system. These standardized codes, maintained by the American Medical Association (AMA), serve as a universal medical language for reporting medical, surgical, and diagnostic procedures and services to entities such as insurance companies, accreditation organizations, and government programs. We go […]
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Behavioral health billing is a complex and crucial aspect of the healthcare industry, specifically focused on mental health and substance abuse services. It involves intricate processes, numerous codes, and strict regulations to ensure accurate reimbursement for services provided while maintaining patient privacy and data security. We research the various mechanisms used in behavioral health billing, […]
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If you’ve ever stepped foot in a medical facility or had any kind of healthcare service, you’ve likely encountered the wonderful world of medical billing. But have you ever stopped to think about the different billing methods used? Specifically, the distinction between institutional billing and professional billing? No? Well, buckle up because we’re about to […]
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If you’re a healthcare provider looking to get into remote patient monitoring (RPM), one of the first things you need to understand is how to bill for these services. And that starts with knowing the right CPT codes to use. RPM has been around for a while, but it really took off during the COVID-19 […]
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Breast cancer is one of the most common cancers among women in the United States, with about 1 in 8 women developing invasive breast cancer over their lifetime. As breast cancer incidence has increased over the past several decades, advances in screening, diagnosis, and treatment have also greatly improved. Breast cancer death rates have fallen […]
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In the intricate world of medical billing and coding, understanding Common Procedural Terminology (CPT) codes is paramount. These codes act as a universal language, facilitating seamless communication between healthcare providers and insurance entities. Let’s delve into the realm of CPT codes, exploring their significance and shedding light on the most commonly used ones. Decoding CPT […]
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Diagnostic testing for COVID-19 has become a cornerstone of pandemic response for healthcare providers. However, rolling out testing services presents immense challenges around reimbursement and revenue cycle management. This definitive use case walks through COVID-19 testing billing and coding procedures in 2022 step-by-step, using examples to illustrate how to optimize claims submission and payment across […]
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Telestroke and teleneurology refer to the use of telehealth to provide acute stroke care and neurological care from a distance. This allows neurologists and stroke specialists to evaluate and manage patients in hospitals or clinics that may not have specialty care available onsite. The use of telehealth and virtual care models in neurology has grown enormously […]
coding and billing, CPT codes, E/M, E/M codes, E/M services, E/M Visits, HIPAA, HIPAA-compliant Telehealth, Tech-enabled Care Models, Telehealth Billing, Telemedicine, Telemedicine Billing, Telemetry, Teleneurology, Teleneurology Billing, Teleneurology CPT Codes, Telestroke, Telestroke Billing, Telestroke CPT CodesImproper bundling in medical billing can lead to denied claims, payment delays, audits, fines, and even fraud allegations. As a medical billing professional, it’s crucial to understand how to bundle procedures correctly to ensure proper reimbursement while adhering to CMS guidelines. In this guide, we’ll cover everything you need to know about avoiding improper bundling […]
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Speech-language pathology services are critical for evaluating and treating communication disorders, swallowing difficulties, and cognitive-linguistic impairments. However, selecting the proper CPT codes for speech therapy can be complex given the many types of assessments, modalities, and interventions provided. We examine the most frequently used Current Procedural Terminology (CPT) codes that speech therapists report to receive […]
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Navigating CPT Coding for Pharmacogenetic (PGx) Testing Reimbursement Pharmacogenetics refers to the study of how genetic variability impacts drug response. Also called pharmacogenomics, PGx testing analyzes a patient’s genetic makeup to predict drug efficacy, optimal dosing, and risk of adverse reactions. As our understanding of genetics has advanced, there has been growing recognition of its […]
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In the realm of medical billing and coding, precision and accuracy are paramount. Hospitalist billing, a specialized area, relies on specific CPT (Current Procedural Terminology) codes to ensure proper reimbursement for services rendered. These codes serve as a universal language that communicates medical procedures and services to insurance companies. In this comprehensive guide, we’ll delve […]
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How to Choose the Correct CPT Code for Your Medical Billing and Coding Services As a medical biller or coder, choosing the correct Current Procedural Terminology (CPT) code is crucial for accurate reimbursement. However, with thousands of codes available, it can be overwhelming to find the right one for your services. We offer a free […]
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Toxicology testing is the analysis of biological samples, such as urine or blood, to detect the presence of drugs or other substances. The results of these tests can be critical in determining a patient’s treatment plan, medication management, or drug rehabilitation program. Toxicology labs play a crucial role in the diagnosis and treatment of various […]
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The COVID-19 pandemic has impacted the world significantly, causing widespread illness, death, and economic disruption. The virus, also known as SARS-CoV-2, primarily spreads through respiratory droplets when an infected person talks, coughs, or sneezes. COVID-19 symptoms range from mild to severe and may include fever, cough, fatigue, body aches, loss of taste or smell, and […]
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In behavioral health, medical billing is a crucial aspect of providing services to patients. The billing ensures that healthcare providers receive proper payment for the services they provide, and it helps patients understand the costs associated with their care. As the healthcare industry continues to evolve, it is important for behavioral health providers to understand […]
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Medical Billing and Credentialing Differences Medical billing and credentialing for medical providers are two different categories in the healthcare world. Before any medical billing can even be completed, the healthcare provider needs to be credentialed with insurance companies in order to be an approved provider of services. Becoming credentialed as an in-network provider dictates the […]
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