A critical element of medical billing services is using the right Current Procedural Terminology (CPT) codes. While some of these codes have not changed in many years, the American Medical Association updates the list annually to be sure that it reflects the latest technology and best practices. It is the doctor’s responsibility to keep up with these changes and to make sure that the information is passed down through the revenue management cycle.
Major changes that were announced in September 2018 affects the way that physicians can bill for patients that they are monitoring digitally. CPT code 99453 is used for monitoring patient’s weight, blood pressure and other vitals remotely and for patient education surrounding the equipment. This is the code that should be used when new equipment is introduced to the patient. Meanwhile, code 99454 is used for monitoring the equipment itself. Finally, 99457 is used when a patient and a member of a doctor’s team interact for more than 20 minutes monthly. While these services can be performed by nurses or medical associates, it is important to note that the doctor must be in the same building when the monitoring is done. The American Medical Association, however, did not specify which devices are covered. In order to qualify for these codes, a face-to-face meeting is required at least once a year.
There are several reasons that the remote monitoring codes were changed. The desire of the American Medical Association is to allow doctors to operate at the top of their certificates allowing patients who are doing well with self-monitoring to not have to interact with the doctor. Alternatively, the doctor can spend their time with patients who need more acute monitoring.
The changes affect the codes that doctors need to be using to bill for remote monitoring. In particular, the American Medical Association who releases the CPT codes revised their 2019 update in March 2019 allowing code 99457 to be used when those working under doctor’s supervision are proving the care. Getting the right codes submitted from medical providers is the first step in successful medical billing services.
Getting the right codes submitted is the first step in revenue cycle management. Then, a revenue cycle management company, like the experts at Signature RCM, can take over the process from there by getting those claims submitted in a timely manner and resubmitting any that are not paid the first time. Additionally, they can help create your Electronic Remittance Advice and your Electronic Funds Transfer requests. They can prepare daily, monthly and annual reports helping you understand your cash flow. Your revenue cycle management company can also help with providing credentials and contract negotiations.
If you are ready to stop working for free and need assistance with medical billing services, then call Signature RCM today at 216-410-1777.