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Basics of CPT code 97124 Generally, massage is a technique of applying light or firm pressure, with different movement styles, using palms, fingers, and thumbs, over body muscles and tissues in order to restore better blood circulation, relax muscles, and stimulate soft tissues. A massage expert or a therapist performs various types of stroking and … Read more
In today’s fast-paced world, healthcare providers are facing numerous challenges. One of the most significant obstacles is managing patient carepass effectively. Carepass management is the process of coordinating and tracking patient care across multiple providers and care settings, ensuring that patients receive comprehensive and timely care. Carepass management involves identifying and addressing gaps in care, … Read more
Claim Adjustment Group Codes In the healthcare industry, Claim Adjustment Group (CAG) codes serve as a standardized system of categorizing and identifying the various reasons why insurance claims have been denied or adjusted. These codes are used by insurance companies and providers to communicate the reasoning behind the adjustments made to a claim. There are … Read more
Basics of Remittance Advice Remark Codes (RARC) Remittance Advice Remark Codes (RARC) provide additional information about an adjustment already described by a CARC and communicate information about remittance processing. Remittance advice remark codes are important codes that are used by healthcare providers and insurance companies to communicate important information about medical claims. These codes provide … Read more
Each edit is associated with a disposition. For example, there can be a rejection of the line item itself or a rejection of the entire claim. In addition to edit dispositions, the program assigns an overall disposition to the claim. The below lists the edits currently applied to non-OPPS hospital outpatient claims with their dispositions. … Read more
Payment adjustment flag 0 – No payment adjustment 1 – Paid standard amount for pass-through drug or biological (status indicator G) (discontinued effective October 2016, v17.3) 2 – Payment based on charge adjusted to cost (status indicator H) (discontinued effective October 2016, v17.3) 4 – Deductible not applicable (specific list of HCPCS codes) or condition … Read more
Status Indicators “It is a payment indicator that identifies whether a service represented by a CPT or HCPCS code is payable under the OPPS APC or another payment system” A – Services not paid under OPPS; paid under fee schedule or other payment system, including unclassified drugs and biologicals reportable under HCPCS code C9399 B … Read more
Although when coding OB/GYN, the particular ICD-10 codes are rarely used because medical coders know exactly which codes to use for which patient symptoms. These codes rarely show up in the offices of other emergency or cardiology professionals due to the delicate nature of women’s health. As a result, when coding and billing for OB/GYN … Read more
Eligible Professionals for PQRS Under Physician Quality Reporting System (PQRS), covered profession al services are those paid under or based on the Medicare Physician Fee Schedule (PFS). To the extent that eligible professionals are providing services which get paid under or based on the PFS, those services are eligible for PQRS incentive payments and/or payment … Read more