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Oregon

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Expert knowledge of all the states guidelines and Medical Billing Process. And expert knowledge of Medical Coding

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Detailed guide on Oregon

In Oregon, MZ Medical Billing services, medical coding follows standardized code sets established by national organizations such as the American Medical Association (AMA) and the Centers for Medicare & Medicaid Services (CMS). These codes are essential for accurately describing medical procedures, diagnoses, and services provided to patients. Here's an overview of the specific coding systems used by MZ Medical Billing:

  1. Current Procedural Terminology (CPT):
    • MZ Medical Billing utilizes CPT codes, developed and maintained by the AMA, to describe medical procedures and services provided by healthcare professionals.
    • Examples of CPT codes include:
      • 99213 - Office or other outpatient visit for the evaluation and management of an established patient, which requires a medically appropriate history, examination, and straightforward medical decision-making.
      • 63047 - Laminectomy, facetectomy, foraminotomy, or excision of herniated intervertebral disc, lumbar, single segment; each additional lumbar interspace (List separately in addition to code for primary procedure).
  2. International Classification of Diseases (ICD):
    • MZ Medical Billing uses ICD codes, developed and maintained by the WHO, to classify and code diagnoses, symptoms, and medical conditions.
    • Examples of ICD-10-CM codes include:
      • M54.5 - Low back pain
      • J44.0 - Chronic obstructive pulmonary disease with acute lower respiratory infection
  3. Healthcare Common Procedure Coding System (HCPCS):
    • MZ Medical Billing utilizes HCPCS codes, developed and maintained by CMS, primarily for billing Medicare, Medicaid, and other insurance payers.
    • Examples of HCPCS Level II codes include:
      • G0438 - Annual wellness visit, including personalized prevention plan services, first visit
      • J3490 - Unclassified drugs
  4. National Correct Coding Initiative (NCCI):
    • MZ Medical Billing adheres to NCCI guidelines, established by CMS, to prevent improper payments when certain code combinations are reported together on claims.

Medical coders at MZ Medical Billing play a crucial role in accurately assigning these codes to document the services provided to patients and facilitate reimbursement from payers. They must stay updated on coding changes and guidelines issued by relevant authorities to comply with billing regulations and optimize revenue cycle management for healthcare providers.

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