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Complexity & Impact of Billing & Coding

RCM Starts with Verification of Benefits

Yesterday, my association's message board was buzzing with an intriguing conundrum presented by a colleague. This owner of a revenue cycle management company is entangled in the labyrinth of Blue Cross' credentialing process. The timelines offered are absurd. And sadly, real.

Use Code 99214 for patients with moderate complexity of treatment. The visit is completed within 30-39 minutes according to AMA (American Medical Association). Furthermore, use this code during a visit with an established patient that has a progressing illness or acute injury requiring medical management or potential surgical treatment. Integrity reviews your practice's coding to ensure that your data accurately reflects current clinical practice and any innovation in medicine.

Understanding the correct medical codes to use can be a daunting task, especially when it comes to the commonly used CPT code 99213. This code is typically used for an established patient office or other outpatient visit that lasts under half an hour. But what if you need to upcode or downcode? Let's delve into the details.

Behavioral health services include psychology, psychiatry, and clinical social work. Running a behavioral health facility has several responsibilities to its patients. One of the very important responsibilities includes having accurate coding in the billing department. This can prove to be a challenge for some clinics that begin to struggle with the gaps of day-to-day medical coding. Per Integrity's COO Denise Corbisiero, "Let us remember that behind every accurate claim is a person seeking healing and support, deserving nothing less than our utmost diligence and integrity."