Articles related to CODING & REIMBURSEMENT

According to Elizabeth Cifers, MBA, a practice management consultant specializing in retina practice: “The key is to focus on medical necessity for the information the test will provide, rather than ordering an OCTA routinely.”

“The goal is to advance scientific rigor, cultural inclusivity, and adaptability while ensuring that the DSM remains useful to clinicians and remains a trusted, relevant tool for understanding and treating mental disorders.” – Marketa M. Wills, MD, MBA

“When 60% of ‘not medically necessary’ denials are reversed…we’re seeing algorithmic denial for delay’s sake.” — Anthony J. Paravati, MD, Kettering Health

Although surgical retina procedures may use similar techniques, the CPT code that accurately reflects the surgery performed is often best identified by the diagnosis that led to the surgery.

Providers nationwide are experiencing an uptick in health plans denying payments by improperly asserting that providers are not coding their claims correctly.

Medicare reimbursement for RPM remains lowest in rural areas where chronic disease prevalence exceeds national averages and provider access presents significant challenges.