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Billing for Exercise Is Medicine: An Analysis of Reimbursement Trends for Physical Activity-Related Billing Codes.
J Phys Act Health
December 2024
Center for Obesity Research, Innovation & Education, Digestive Health Institute, Hartford Healthcare, Hartford, CT, USA.
Background: Physical inactivity is a significant health risk factor linked to chronic diseases and premature death. To address this, initiatives like Exercise is Medicine® aim to promote physical activity in health care systems. However, integrating physical activity counseling into clinical practice faces barriers such as limited reimbursement.
View Article and Find Full Text PDFCritical Care Billing in 2023.
J Cardiothorac Vasc Anesth
March 2024
Department of Anesthesiology, Vagelos College of Physicians & Surgeons, Columbia University, New York, NY. Electronic address:
Because of changing rules and regulations in insurance and reimbursement, critical care physicians must adapt their billing practices to meet the challenges of these complex changes. Reimbursement for critical care billing varies substantially across the country, and staffing models must consider this heterogeneity. This article summarizes the current state of critical care billing and addresses the requirements to generate a critical care bill and the potential circumstances that may result in a denial of payment.
View Article and Find Full Text PDFTrends in Emergency Department Exam Medicare Reimbursements Between 2010 and 2018.
Cureus
July 2024
Emergency Medicine, Mayo Clinic, Phoenix, USA.
Background: As the Medicare population continues to grow, financial pressure is placed upon hospitals, physicians, and other providers as the payer mix has an increasing proportion of Medicare patients.
Objective: The purpose of this study was to further the understanding of reimbursement trends surrounding the five levels of emergency department (ED) examinations (CPT codes 99281-99285) from 2010 to 2018 and determine how they have changed with respect to each procedure.
Methods: CPT codes were filtered into the 2010 and 2018 Physician/Supplier Procedure Summaries from the Centers for Medicare and Medicaid Services' website to gather data on emergency physician submissions and Medicare denials and payments.
Essentials of Point-of-Care Ultrasound Coding and Billing at the Neonatal Intensive Care Unit Setting in the United States.
Am J Perinatol
October 2024
Division of Neonatology, Department of Pediatrics, Loma Linda University School of Medicine, Loma Linda University Children's Hospital, California.
Point-of-care ultrasound (POCUS) has increasingly been used by neonatal providers in neonatal intensive care units in the United States. However, there is a lack of literature addressing the complexities of POCUS coding and billing practices in the United States. This article describes the coding terminology and billing process especially those relevant to neonatal POCUS.
View Article and Find Full Text PDFMulti-Institutional Analysis of Insurance Denial Patterns Within Rhinology.
Am J Rhinol Allergy
July 2024
Department of Otolaryngology-Head and Neck Surgery, Houston Methodist, Houston, TX, USA.
Background: Obtaining insurance approval is a necessary component of healthcare in the United States and denials of these claims have been estimated to result in a loss of 3% to 5% of revenue.
Objective: Examine the trends in insurance denials for rhinological procedures.
Methods: A retrospective review of deidentified financial data of patients who were treated by participating physicians across 3 institutions from January 1, 2021, to June 30, 2023.
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