New Medicare Modifiers XE, XP, XS, XU: Examples of When to Bill Each One

February 13, 2024 / admin / Articles, CMS, Coding, Healthcare, Healthcare Billing, Medical, Medical Billing, Medicare Modifiers, Modifier Code, Modifier XE, Modifier XP, Modifier XS, Modifier XU, Modifiers, X{EPSU}, X{EPSU} Modifiers, XE, XP, XS, XU

Effective January 1, 2022, the Centers for Medicare & Medicaid Services (CMS) introduced four new HCPCS modifiers for Medicare claims: XE, XP, XS, and XU. These modifiers provide more specificity around the circumstances of service provided. Using these new modifiers correctly is essential for ensuring accurate reimbursement. We provide an overview of modifiers XE, XP, […]

CMS, HCPCS, Medicare Modifiers, Modifier XE, Modifier XP, Modifier XS, Modifier Xu, XE, XE: Separate encounter, XP, XP: Separate practitioner, XS, XS: Separate structure, XU, XU: Unusual non-overlapping service

What are and When to Use Modifier Codes

February 10, 2024 / admin / Anatomic Modifiers, Articles, Bilateral Surgery Modifiers, CMS, Coding, CPT, CPT Codes, CPT Definitions, Global Surgery Modifiers, HCPCS Codes, Medical, Medical Billing, Medical Coding, Missing Modifiers, Modifier Codes, Modifiers, Procedure Modifiers

Modifier codes are an important part of medical billing and coding. They provide additional information about a medical procedure or service to help ensure proper reimbursement. Knowing when to use modifier codes can improve claim accuracy and prevent costly payment delays or denials. We explain what modifier codes are, why they are used, the most […]

Anatomic Modifiers, Bilateral Surgery Modifiers, Billing, Coding, Coding and Billing, CPT, CPT definitions, CPT-10, Global Surgery Modifiers, HCPCS, Healthcare, Healthcare Billing, Medical, Medical Billing, Medical Coding, Medical Necessity, NCCI, NCCI Edits, Payer Policies, Procedure Modifiers, Revenue Cycle, Revenue Cycle Management, Revenue Cycle Optimization

The Essential Guide to Avoiding Improper Bundling in Medical Billing

February 6, 2024 / admin / Articles, Bundling, Component Codes, Improper Bundling, Medical Billing, Medically Unlikely Edits, Modifier Code, Modifier Codes, Modifiers, MUEs, National Correct Coding Initiative, NCCI, NCCI Edits, Proper Bundling, Unbundling

Improper 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 […]

Claim Denials, Component Codes, Comprehensive Code, CPT, CPT codes, Denied Claims, Denied Medical Claims, HCPCS, Medically Unlikely Edits, Modifier Codes, MUEs, National Correct Coding Initiative, NCCI, NCCI Edits, Unbundling

Which CPT Codes are Used in Oncology Billing?

January 28, 2024 / admin / Articles, Billing, Biopsy Billing, Cancer Billing, Chemo Billing, Chemotherapy Administration Codes, Chemotherapy Billing, E/M Codes, E&M Services, HCPCS, Medical Billing, Nuclear Medicine Billing, Oncology, Oncology Billing, Oncology CPT Codes, Radiation Oncology Services, Treatment Complications

Oncology billing involves the use of many complex CPT codes to accurately report services provided to cancer patients. Choosing the right codes is critical for ensuring proper reimbursement and compliance with billing guidelines. We provide an overview of the most common CPT codes used in oncology billing and coding. Evaluation and Management (E/M) Codes E/M […]

Biopsies/Procedures, Cancer, Cancer Billing, Chemo Billing, Chemo Drugs, chemotherapy administration, Chemotherapy Administration Codes, Diagnostic Injections, E/M services, HCPCS, Lab/Pathology, Medical Oncology Services, Nuclear Medicine, Nuclear Medicine Billing, Oncology Billing and Coding, Pain Management, Prophylactic, Radiation Oncology Services, Radiation Therapy, Therapeutic, Therapeutic Injections, Treatment Complications