CPT codes

How To Handle Unlisted Codes To Prevent Denials

The healthcare industry continues to evolve with new services, care devices, medications, and treatment techniques being developed each day. These advancements are entering the field faster than ever before. Many of them have new CPT codes affecting their use and applications. Yet the American Medical Association (AMA) can sometimes take as much as 18 months to 2 years to come out with modified CPT codes and instructions for some of these new advancements. This can lead to a plethora [...]

By |August 26th, 2022|Categories: Tips|Tags: , , |0 Comments

What Is CPT Code 99284 & How To Know When To Use It

Errors in medical billing codes tend to be one of the most common reasons that a claim is denied or rejected by mental and behavioral health payers. Not only can this lead to massive delays and inconsistencies in your practice’s revenue stream, but it can cause other long-term complications. A solo practitioner or a small practice that has frequent medical coding errors can sometimes draw a red flag from a private insurance company, public health institution, or another type [...]

By |July 21st, 2022|Categories: Tips|Tags: |0 Comments

What Is CPT Code 99202 & How To Know When To Use It

Knowing when and how to correctly apply a CPT code is one of the most challenging aspects of mental health insurance billing. It typically requires the memorization and correct application of a staggering array of CPT codes. For a lot of solo practitioners, small practices, and ABA therapists, knowing exactly when to use a specific CPT code and in what situation can feel daunting. Yet accuracy is exactly how providers secure prompt payment from a “Clean Claim” that is [...]

By |July 20th, 2022|Categories: Tips|Tags: |0 Comments

What is CPT Code 97151 for ABA Therapy?

After August 1st, 2021 all authorizations requested on or CPT code 97151, for assessment and treatment plan development, need to be authorized for up to 32 units. This translates into a total of 8 hours for an initial assessment, which is broken down into 24 units, comprising up to 6 hours for all subsequent authorization periods. Though it’s also worth noting that CPT code 97151 still needs to be conducted over 14 calendar days or less. This means that [...]

By |March 5th, 2022|Categories: Tips|Tags: , , |0 Comments

99211 CPT Code Use Case Scenarios For ABA Therapy

CPT codes play a critical role in medical billing. Using the wrong code in the wrong place or for an incorrect type of diagnostic or treatment process can lead to potential claim rejections and denials. Not to mention a very serious risk of delays in your practice’s revenue stream. One of the CPT codes that come under scrutiny by some insurance providers and public health institutions is the 99211 CPT code. Though knowing precisely when to use this 99211 [...]

By |January 18th, 2022|Categories: Tips|Tags: , |0 Comments

What Is A Medical Coder And What Do They Do?

Accurate medical billing plays a critical role in ensuring that physicians get paid consistently and at a reimbursement level that is appropriate for their credentials, the type of treatment administered, and any specialist services they offer. Of course, this reimbursement also affects their ability to do other essential things like pay administrative staff, update their medical equipment, purchase new medical supplies, and even pay their in-house administrative staff. Errors and missing information in a claim that’s accidentally submitted to [...]

By |March 12th, 2021|Categories: Tips|Tags: , , |0 Comments

Top ICD-10 Codes for Mental and Behavioral Health

Accurately medical billing is not an easy task for a lot of small practices and solo practitioners. The wide range of evolving terms and acronyms used for even the most simple of services can be exceedingly complex. An incorrectly used code or even a simple piece of missing information can lead to significant delays in your revenue stream as well as increasing the risk for a claim rejection or claim denial. As the various code books continue to evolve [...]

By |March 12th, 2021|Categories: Tips|Tags: , , |0 Comments

New 2021 E/M Coding Changes You Should Know

Every year payers and public health institutions like the Centers for Medicare and Medicaid Services and the American Medical Association implement changes to their Evaluation and Management coding. Like clockwork, these changes were implemented on January 1, 2021. Physicians and medical practices of every scale need to educate themselves and their staff on these changes to minimize any delays and reduce the risk for potential questions when filing a claim or requesting prior authorization. This also helps ensure that [...]

By |February 9th, 2021|Categories: Tips|Tags: , , |0 Comments

How To Use Medical Billing CPT Modifiers Correctly

Medical billing professionals often have to use modifiers to affect the description of a diagnostic process, treatment plan, or other service performed for a client. This also includes things like prescriptions or other medical supplies that may have been provided to a patient as part of an effective treatment plan. What Are CPT Code Modifiers? A CPT code modifier is a two-digit code that is specifically linked to a CPT code that needs a further description of the [...]

By |February 9th, 2021|Categories: Tips|Tags: , , |0 Comments

What is CPT Code 90791; When & How To Use It

CPT Code 90791 is one of the CPT codes most commonly used by licensed behavioral health providers. It is used as part of an integrated biopsychosocial assessment, this includes key details like the patient’s mental state, their history, and recommendations. CPT Code 90791 is typically used for diagnostic evaluations that are related to new behavioral health concerns or illnesses. It’s usually billed for the initial intake appointment and evaluation that each new patient needs to go through at the [...]