Archive for the Week of September 11, 2005
Archive for the Week of September 11, 2005
Welcome to the medical billing blog archive for the week of September 11, 2005.
Here you will find links to every article added to the Outsource Management Group web site during the week of September 11, 2005.
You can browse this week's archives by clicking the "More" button from any of the excerpts below.
Emergency Medicine Medical Billing
Emergency Medicine Medical Billing Emergencies can not be planned and they can’t be scheduled. There are no preapprovals and a lot of times documentation is sparse and these are among the hardest medical billing claims to get paid. Emergency procedures are performed in a fast paced environment and there can be several people performing multiple duties and not all those procedures get noted on the documentation. When it comes time to compile the medical billing form. The coding will have to considered carefully. You obviously can’t have certain procedures done without others being included. For example there may not be the suturing procedure listed as it might have gotten missed …
Reasons For Medical Billing Reversals
Reasons For Medical Billing Reversals Reversals can happen for a myriad of legitimate and not so legitimate reasons. In a recent study, the top reasons for medical billing reversals are as follows: 1- Incorrect payable diagnoses codes, the biggest offenders in this category were: Modifier 59 – distinct procedural serviceModifier 76 – repeat procedure by same physician Modifier 24 – unrelated evaluation and management service by same physician during postoperative periodModifier 25 – significant separately identifiable evaluation and management service by same physician on the day of a procedure. 2-Provider Billing Errors – As long as medical billing is coded by humans, there will be errors, that’s just a fact …
Payers Treat Group Practices as 1 Provider
Payers Treat Group Practices as 1 Provider Medical billing rules can get hazy when dealing with group practices. It is difficult to determine if physicians within a group should bill separately for follow up care if another physician performed the actual surgery. There are rules to follow in this type of situation that make medical billing easier to understand. When there is a group of physicians in the same practice, usually one does surgery. With surgery there is usually follow up care that is bundled in the CPT code for medical billing. This means that surgeons cannot bill separately for follow up care and for the surgery. This also goes …
Hospital Coding For Medical Billing Claims
Hospital Coding For Medical Billing Claims Hospitals can be fast paced, shift changes and sometimes the lack of documentation can all hinder the reimbursement process for your medical billing claims. Hospital coding techniques can vary greatly since so many individuals handle the coding and documentation and usually they require a good deal of overview. Medical billing for out patient and X-ray labs is usually very cut and dried to process as you only need to check the orders for necessity (especially for Medicare medical billing claims) and you need to make sure you have the proper documentation prior to submitting your medical billing claims. Asking for missing information in order …
What are Taxonomy Codes?
What are Taxonomy Codes? Even if you’ve only been involved in medical billing for a short time, you have seen taxonomy codes, they are primarily used in the billing of Medicare claims. The taxonomy code is now HIPAA mandatory and necessary for electronic filing of medical billing claims. The taxonomy is a unique alphanumeric code that is 10 characters in length. The code list is structured into three distinct “Levels” including Provider Type, Classification, and Area of Specialization. There is a listing called “The Provider Taxonomy Code List” which allows a single provider (individual, group, or institution) to identify their specialty by category. Providers may have one or more than …
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