The latest updates in medical billing

There are always updates being done in the medical billing and coding so that the billing process continues to speak a universal language that will maintain harmony in the provision of healthcare services. Here are some of the codes that have been updated this year.

Mammography codes – there are three new mammography codes introduced in the 2017 CPT codebook. The codes are meant to describe mammography services and they include computer assisted detection, CAD when it is performed. The new codes are 77065, 77066 and 77067. They have replaced the previous mammography codes that were 77051, 77052, 77055, 77056, and 77057.

77065 - describes diagnostic mammography, including computer aided detection when performed unilaterally.

77066 - describes diagnostic mammography, including computer aided detection when performed bilaterally.

77067 – describes screening mammography, bilateral and includes computer aided detection if performed.

Colonoscopy -  if a healthcare provider is unable to advance a colonoscopy of a Medicare beneficiary due to reasons such as obstruction or patient discomfort then a modifier should be used. The modifier to use is 53 which indicate discontinued services. After that the provider should give adequate information on the condition of the patient in their medical records. The CPT codebook advocates for use of modifier 52 which indicates reduced services. Then the provider is supposed to provide documentation when the code is used.

Telehealth services – if a telehealth service has been provided, then under the CMS an interactive audio and video telecommunication system with real time communication should be used. If such a service is provided then modifier GT should be used. If the service is provided and an asynchronous telecommunications system is used then the modifier GQ should be used. Telehealth should be provided in such a way that both the provider and the patient are in constant two-way communication throughout the session.

Unlisted code – the American Medical Association, AMA, instructs that a CPT code should not merely approximate the service given. It should be exactly the service given. If the code for the service does not exist, then the case should be reported using the appropriate unlisted procedure or service code. The unlisted code numbers refer to a certain section of the book and are represented by guidelines in that section. The coder should explore all other options that they have to state the services given clearly and the unlisted code should be a last resort.  If for instance the procedure has a code but more services were provided then the coder can use modifier 22 which is for unusual procedural service to indicate the extra time and services offered.

Lookout out for updates in the code, so that you do not keep getting refusals for reimbursement of claims, or improper reimbursements. physician billing company Houston