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If you haven’t done so already, employ the help of your biller, billing company or a seasoned administrative staff member to clean up both insurance and patient aging. Start with insurance aging to ensure patient balances are correct before attempting to collect one last time this year.

“Can you describe what is a “sufficiently detailed exam” to confirm the diagnosis of peripheral arterial disease? I was audited and the debridement of calluses were denied even documentation of every single class finding were listed. Are we supposed to do ankle brachial indexes, Buerger’s test, etc.? Why have class findings if they do not qualify as “sufficiently detailed?”

Doctors have a hard enough time treating patients and dealing with basic business operations on a day-to-day basis. It’s a difficult task to ask them to be aware of and in compliance with every section of health care regulatory laws and other standards in addition to their daily provision of care to patients. Simply stated, doctors and other health care professionals and providers face an enormous challenge trying to be aware of, understand, and comply with applicable state and federal health care regulatory laws. Consequently, health care professionals and providers are often completely in the dark on what it takes to spot compliance issues and prevent them from happening before they become serious issues. This level of awareness (or lack of it) can be summed up in one simple statement. You don’t know what you don’t know. And not having this knowledge can lead to devastating consequences.

FDA Recalls December 12 - 16, 2024

“I billed A5500 and A5512 with modifiers -KX, -RT, -LT. L1940 KXRTLT L2330 KXRTLT L2820 KXRTLT I billed these on separate lines. This claim was rejected so we re-billed putting the KX modifier in the 3rd spot and it was still rejected for the same reason. The comment was: 4 – the procedure code is inconsistent with the modifier used or a required modifier is missing Any thoughts on how to tackle this denial?”

FDA Recalls December 02 - 10, 2024