15 articles matching “prior authorization”.
Showing 1 to 15 of 15
Hematology oncology billing covers chemotherapy administration CPT hierarchy 96413-96417 with sequential add-on 96417 and concurrent 96416, cancer drug HCPCS J-code billing with NDC numbers and Modifier JW for single-dose vial wastage an...
Allergy and immunology billing covers percutaneous allergy testing CPT 95004 and intradermal testing 95024 billed per allergen test, allergen immunotherapy split billing between preparation 95165 per dose and injection administration 951...
Infusion center billing requires mastery of drug administration hierarchy rules with one initial code per encounter and sequential add-on codes 96367 and concurrent add-on 96368, therapeutic infusion CPT codes 96365-96368 vs. chemotherap...
Medicare Advantage billing differs fundamentally from traditional Medicare: MA plans have their own fee schedules, prior authorization requirements for services traditional Medicare never requires PA for, HCC risk adjustment coding requi...
Scheduling and pre-registration information capture to prevent downstream denials, insurance eligibility verification timing and 270/271 transaction workflow, prior authorization management including PA matrix maintenance and tracking, p...
PA tracking and workflow management from submission through renewal, PA submission documentation quality, peer-to-peer review and appeals strategy, electronic prior authorization (ePA) implementation, and Gold Carding and PA reform legis...
AI in prior authorization and eligibility, RPA for RCM automation, AI-assisted coding tools, predictive denial management, and how to evaluate RCM technology vendors.
Cardiology billing covers echocardiography TC/PC split 93306, stress testing 93015-93018, nuclear SPECT 78451-78452, cardiac catheterization 93454-93461, PCI codes, EP ablation 93653-93657, ICD implant documentation, and cardiology prior...
Urology billing covers cystoscopy codes 52000-52356 including ureteroscopic procedures, prostate procedure coding for TURP 52601 and robotic prostatectomy 55866, lithotripsy ESWL 50590 and PCNL 50080-50081, urodynamics 51725-51797 with T...
Rheumatology billing covers joint and soft tissue injection codes 20600-20611 with and without ultrasound guidance, biologic DMARD infusion J-codes and Q-codes for biosimilars, infusion administration codes 96413-96415 and 96365-96366, p...
Plastic surgery billing covers the reconstructive vs. cosmetic coverage distinction and documentation requirements, skin graft CPT codes 15100-15278 with area-based measurement, local and free flap closure codes 14000-15758, breast recon...
Radiology billing covers technical component and professional component split billing with Modifier TC and Modifier 26, diagnostic imaging CPT codes for X-ray CT MRI and ultrasound, interventional radiology catheterization and drainage p...
Oncology billing covers chemotherapy administration codes 96401-96549 including sequential and concurrent infusion hierarchy, antineoplastic drug J-codes and unit calculation, NDC documentation, buy-and-bill ASP+6% economics, immunothera...
DME billing covers HCPCS Level II E-codes and K-codes, DMEPOS supplier accreditation standards, Certificate of Medical Necessity CMN documentation, oxygen therapy and power wheelchair coverage criteria, competitive bidding program, and p...
Neurosurgery billing covers spine surgery CPT codes for ACDF 22551-22552 and lumbar fusion 22558-22630 with multi-level add-on coding, spinal instrumentation 22840-22848 and interbody device 22853-22854, craniotomy codes 61304-61576 for...
