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CPT Codes Preparation Checklist

2019 is close, and the new CPT Codes are released on January 1 and on July 1.

Carriers might not be using these new codes on 1/1/19, but they are looking to adopt the new codes.
Please know there is NO guarantee every Insurance Company will have the codes already set and ready to go by 1/1/2019. Many have stated they will not be ready on 1/1/19.

Be prepared:

  1. Talk to your payers and find out if the new codes will be adopted, or the dates when they will be adopted. If you don’t get these dates, check back with the insurance carriers, as they have up to six months (-ish) to accept/adopt new codes
  2. When you know the date the payer(s) will be implementing the new codes, ask for a new fee schedule.
  3. Once you receive the new fee schedule, compare it to your current fee schedule to make sure the rates are equal. The new codes are 15- minute increments, so there will be some differences in the rates.
  4. Make sure your contracts and fee schedules show the new codes with the new rates.
  5. Know the definitions of the new CPT codes, and how to use them. Make sure you have complete and accurate information about the new CPT codes.  Download slides from our CPT Code Webinar
  6. Ensure your Practice Management system/Clearinghouse is ready – set up to bill and accept the new codes.
  7. Bill them out and review to confirm these made it to the clearinghouse and to the payer appropriately. If not, be sure to address it quickly so you can maintain a consistent cash flow.
  8. And finally, PHI can help.
    Call: (877) 972-8434
    Email: hi@pathfinderhi.com
    Chat: https://pathfinderhi.com/contact/

Need to know more? How We Can Help

  • PHI can review your contracts and advise on rate negotiations
  • Help you calculate the value of your services
  • Work with and engage with your payers about the new codes
  • Suggest conversions from current codes to the new codes
  • Answer any of your questions

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