Billing Decoded

Ivanko Brnjakovic/stock.adobe.com In today’s complex healthcare landscape, appeals have become a routine and essential part of securing reimbursement for claims....

In O&P, the intake process is far more than just collecting patient demographics—it’s the cornerstone of compliance, accurate billing, and...

Medical necessity is a term frequently encountered in O&P—particularly in the context of insurance coverage, audits, and appeals. Yet despite...

There is a common misperception in the profession that clinical documentation from an orthotist or prosthetist has no bearing in...

What may seem like an act of kindness or generosity, the Office of Inspector General (OIG) considers to be a...

As a supply item, Medicare and many other payers have defined refill requirements that must be followed when providing the...

Many billers and administrative staff are well versed in claim denials related to things like missing or inappropriate modifiers, medical...

Time is a fleeting commodity, stretched thin between our work and personal lives. The lack of time has caused some...

Medicare Pricing Data Analysis and Coding (PDAC) verification rules are often misunderstood, specifically when it pertains to coding and documentation....

Effective August 12, Medicare is expanding its list of Healthcare Common Procedure Coding System (HCPCS) codes for prior authorization, face-to-face...