Procedure Coding: When To Use The Modifiers
Modifiers are valuable coding tools that explain to payers the specific work that was done by a physician during treatment of a patient. They’re important for representing the medical decision-making…
Orthodontic Billing for Sleep Apnea and TMD
Note on Documentation Requirements: Establishment of medical necessity of pediatric orthodontics requires documentation to support the severe handicapping malocclusion and the presence of a qualifying medical condition, and a score…
Medicare On Line Coverage
The Centers for Medicare & Medicaid Services has launched a new “What’s Covered” app that allows Original Medicare enrollees and caregivers using mobile devices to determine coverage for specific medical…
You could be loosing money by not using Modifiers correctly.
Using Modifier 59 CPT Manual defines modifier 59 as a “Distinct Procedural Service“. The 59 modifier is considered the most misused modifier by coders. It is normally used to indicate that…
What Diagnosis Codes Should I Use for TMJ Headache Massage for Coverage
From our Friends at Find-A-Code: Question: We have been receiving several DDS referrals to our massage therapists who do intra-oral work. The only problem is that the referral from the…
EXPAREL One of the Newest Dental Codes for 2019
Arlington, Va. – Dominion National, a leading dental insurer and administrator of dental and vision benefits headquartered in Arlington, Va., announced a new initiative to lead the fight against the…
Dental vs. medical insurance: Where do the two diverge?
Written by Mackenzie Garrity on May 29, 2018 Our industry is moving into more medical billing, just by the fact that dental has not increased their benefits and many services…
Setting up and why with CAQH
There are solutions to help you set up Medical Billing in order for them to know who you are. You are also able to do credentialing with them.
Physical Status Modifier (For Anesthesia)
Many offices are not using the modifier to tell the insurance company the health of the patient. If you are not receiving payment use the correct modifier for each patient….
Why Federal Truth in Lending is important
Federal Truth-in-Lending Act All policies and procedures used in collection must conform with both federal and state law, and any applicable ethical obligations. At the federal level, physicians who want…
Billing Aetna Medical for Ortho
This form is used to evaluate the conditions that may or may not qualify patients for coverage of medically necessary orthodontic services. Medically Necessary Orthodontia related to the Pediatric Dental…
Medicare and Dental Coverage
Medicare’s dental coverage is limited. If you have Original Medicare (Part A and Part B), you won’t be covered for most dental services and supplies, including: Dental exams Routine cleanings…