Medical Billers and Coders

  “General Surgery” is a discipline of surgery having a central core of knowledge embracing anatomy, physiology, metabolism, immunology, nutrition, pathology, wound healing, shock and resuscitation, intensive care, and neoplasia, which are common to all surgical specialties. Due to the numerous illnesses looked after by a general surgeon, the billing and coding (for surgical sub-specialties too) often come with numerous challenges as well. The complexities of coding, procedure rules manifold, and complex contractual adjustments are required to be addressed with care and expertise for apt and timely reimbursements. The complexities include being knowledgeable about the latest rules such as moderate sedation being separately billable, the addition of new mammography codes, new coding for endovascular ablation and endovascular revascularization, under Hemodialysis access – coding for angioplasty and stent placement, thrombolysis or Thrombectomy, a new option for GERD – esophageal sphinc

  Surgical Assistants Practices lose insurance reimbursement by incorrectly billing surgical assistants. In such cases, the major reason for claim denials is to use the wrong modifier/ not use the modifier. In this blog, we tried to cover every aspect of billing for surgical assistants including defining surgical assistants, billing guidelines, reimbursement policies, and accurate use of modifiers. Surgical assistance services can be provided by a Health Care Professional other than a Physician (i.e., Physician Assistants (PA), Nurse Practitioners (NP), or Clinical Nurse Specialists (CNS) in accordance with the requirements outlined in Medicare Claims Processing Manual Chapter 12. Surgical assistants include co-surgeons, assistant-at-surgery, and team surgeons. Co-Surgeons are defined as two or more surgeons, where the skills of both surgeons are necessary to perform distinct parts of a specific operative procedure. Co-surgery is always performed during the same operative session.

Medical billing and coding for general surgery are not as simple as you think. Besides being educated in procedures ranging from hernia repair to bladder surgery, the billing and coding staff need to be knowledgeable in the proper use of the global surgical package, modifiers for surgeon roles and same-day procedures, and citations for unlisted procedures. Mistakes can lead to lower reimbursements and cause compliance issues. The General Surgery Billing Pitfalls are issues that many hospitals and medical facilities experience and can be avoided with practice and patience. General Surgery Billing Pitfalls A medical billing, coding, and  revenue cycle management  association can assist your billing staff by performing periodic audit risk assessments, helping minimize compliance issues, and helping your practice bill more efficiently and effectively. Depending on your facility’s general surgery practice needs, you may also benefit from outsourcing all or part of your billing, coding, and

Physicians in general surgery are facing an uphill task of medical billing keeping in check the different needs of the facilities and keeping a tab on the effective revenue cycle management to look for frequent denials and which of the claims need more efficient coding. The channel of insurance payment has been one of the most straining factors for general surgery physicians today affecting the bottom line of the revenue and in turn affecting the facility.  Individual physicians have a high cost of staffing and also   revenue management   which has led to many of them being absorbed by groups acquired by the hospital. General Surgery is one such facility that has seen a rise in individual costs and most of the facilities are either in the group or combined with hospitals. Tracking different types of patient care from appointment scheduling to registration and different steps for collection of the balance fall under revenue cycle management. The healthcare revenue cycle is a financial s