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As an employee or potential candidate for a company, one of the most important benefits to consider is health insurance. Having access to quality healthcare can mean the difference between financial stability and bankruptcy in the event of a medical emergency. For those considering employment with Robert Half, a leading staffing agency in the United … Read more
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 CPT code for Tonsillectomy/Adenoidectomy A tonsillectomy is a surgical procedure to remove the tonsils. Tonsils are two small glands located in the back of your throat. Tonsils house white blood cells to help you fight infection, but sometimes the tonsils themselves become infected. Specific codes are assigned for coding tonsillectomy. CPT code 42825 and 42826 … 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