Insurance Billing and Coding

Can a person over 65 and covered by Medicare Part B choose either a group or individual setting for Intensive Behavior Therapy for Obesity (G0447) and expect it to be covered by Medicare?
According to CMS, “the national coverage determination (NCD) for IBT for Obesity does not preclude group visits…”
Fri, 6 Jun, 2014 at 12:25 PM
What is “Incident to” and how does it affect my medical practice?
According to CMS  “Incident to a physician’s professional services means that the services or supplies are furnished as an integral, although incidental, ...
Fri, 18 Apr, 2014 at 11:52 AM
Does insurance cover treatment for obesity?
In many cases yes. Every policy is different so benefits need to be verified for each patient. The Affordable Care Act and it’s enhanced coverage for prev...
Fri, 18 Apr, 2014 at 11:52 AM
Can someone other than a physician see patients for obesity?
Yes. Physicians, nurse practitioners, physician assistants, registered dieticians (must be following the physicians plan of care) and other “non-physician...
Fri, 18 Apr, 2014 at 11:52 AM
What is the difference between the Health Insurance Marketplace and the traditional insurance market?
The marketplaces will improve today’s broken insurance markets for consumers and small businesses. They achieve this by: · More Choice. Consumers wi...
Fri, 6 Jun, 2014 at 12:25 PM
How do I know if I have a PECOS Record?
There are three (3) ways to verify that you have an enrollment record in PECOS: · Check the Ordering and Referring Report on the CMS website found i...
Fri, 18 Apr, 2014 at 11:52 AM
Why is the transition to ICD-10 happening?
The transition is occurring because ICD-9 codes have limited data about patients' medical conditions and hospital inpatient procedures. ICD-9 is 30 ye...
Fri, 18 Apr, 2014 at 11:52 AM
What type of training will providers and staff need for the ICD-10 transition?
AHIMA recommends training should begin no more than six months before the compliance deadline. Training varies for different organizations, but is project...
Fri, 18 Apr, 2014 at 11:52 AM
What happens if I don't switch to ICD-10?
Claims for all services and hospital inpatient procedures provided on or after the compliance deadline must use ICD-10 diagnosis and inpatient procedure c...
Fri, 18 Apr, 2014 at 11:52 AM
Codes change every year, so why is the transition to ICD-10 any different from the annual code changes?
ICD-10 codes are different from ICD-9 codes. ICD-10 has a completely different structure from ICD-9. Currently, ICD-9 codes are mostly numeric and have 3 ...
Fri, 18 Apr, 2014 at 11:52 AM