CPT code 90791 is a specific billing code utilized within the medical field, particularly in the realm of behavioral health. This code signifies a psychiatric diagnostic evaluation, which is an in-depth assessment of a patient’s mental health. The evaluation is conducted by a licensed behavioral health professional and encompasses a thorough review of the patient’s … Read more
Navigating the maze of Medicare billing and coding can be complex. One of the many aspects that providers must understand is the use of modifiers. These seemingly small additions to claim submissions can have a significant impact on reimbursement. Today, we’re talking about four such modifiers: GA, GX, GY, and GZ. This blog post is … Read more
Navigating the maze of CPT and diagnosis codes for medical procedures can be a daunting task, not just for healthcare providers but also for medical coders, billers, and even patients. Bronchoscopies are a case in point—what seems like a straightforward procedure is actually classified under a variety of codes depending on its complexity, equipment used, … Read more
In the ever-evolving landscape of healthcare, two acronyms have emerged as significant players: IPAs and OPPs. Individual Practice Associations (IPAs) and Organized Provider Practices (OPPs) are two types of healthcare delivery systems that have gained prominence in recent years. They represent innovative approaches to healthcare delivery, aimed at improving patient care and optimizing reimbursement systems. … Read more
The world of healthcare billing can be a labyrinth of complexity, and few areas epitomize this complexity more than the realm of CPT codes. For those unacquainted, Current Procedural Terminology (CPT) codes are the standardized codes utilized to classify and bill medical procedures and services. One area of medical testing that frequently calls upon a … Read more
In the complex landscape of healthcare, Long-Term Acute Care (LTAC) facilities play a critical role. These specialized hospitals are designed to provide extended medical and rehabilitative care for patients with serious health conditions that require a longer hospital stay. LTAC facilities are often a bridge between the intensive care unit (ICU) and a lower level … Read more
Endobronchial ultrasound (EBUS) procedures have dramatically transformed the landscape of respiratory care, particularly in the field of interventional pulmonology. EBUS provides minimally invasive access to lungs and surrounding lymph nodes, offering a safer and more efficient alternative to conventional diagnostic procedures like mediastinoscopy. But while EBUS advances patient care, it also introduces new complexities in … Read more
Emphysematous changes refer to the structural alterations in the lungs caused by emphysema, a chronic lung condition characterized by damage to the air sacs (alveoli) in the lungs. One of the diseases that comprise Chronic Obstructive Pulmonary Disease (COPD), a group of lung diseases that cause airflow blockage and breathing-related problems. Understanding emphysematous changes is … Read more
Steve G. Peters, M.D. is Professor of Medicine in the Division of Pulmonary and Critical Care at the Mayo Clinic in Rochester, MN. Disclosure: Dr. Peters is on the NAMDRC Board of Directors and serves as Advisor to the CPT Panel of the AMA, representing the American College of Chest Physicians. Current Procedural Terminology (CPT®) … Read more
The world of medical billing and coding can be complex and confusing, especially when it comes to understanding the nuances of Current Procedural Terminology (CPT) codes. In this article, we will delve into the specifics of CPT codes 99143, 99144, and 99145, shedding light on their definitions, usage, and the implications they hold for both … Read more