Archive for the Week of October 20, 2006
Archive for the Week of October 20, 2006
Welcome to the medical billing blog archive for the week of October 20, 2006.
Here you will find links to every article added to the Outsource Management Group web site during the week of October 20, 2006.
You can browse this week's archives by clicking the "More" button from any of the excerpts below.
More Audit Triggers in 2007
In 2007 the OIG is planning on zeroing in on incident to billing claims. In the update issued in October 2006, the HHS Office of Inspector General plans to issue a report on whether you are following all the requirements for incident -to billing, including direct physician supervision. The OIG wants to know whether these services met the Medicare standards for medical necessity, documentation and quality of care, according to the OIG’s 2007 Work Plan. Other topics include: Other things that will be closely studied in the report include global periods and how they are determined in the medical billing. The agency will also be in the lookout for assignment …
Medical Billing for Subsequent Hospital Care
A confusing medical billing situation can occur when the ED physician provides subsequent hospital care to a patient. Interpreting the level of eval and management services provided can be a challenge when the coder only has the notes. Many medical billers often err on the side of caution and under-report subsequent hospital care services which results in a much lower reimbursement rate and that hurts the overall revenue flow of the practice. This could occur if a coder fails to realize that she need not satisfy all of the E/M components to report the subsequent care codes. Documentation in the code choices needs to be included as well to insure …
Tuberculosis Test Requires Special Handling
As tuberculosis becomes more prevalent; it’s showing up more often as a coding dilemma. One of the most common questions is if the PPD test should be charged separately and the answer is yes-sometimes. The reason is that when a skin test such as the one for tuberculosis is done, if the results are negative the test will be considered inconclusive for diagnosis; however if the results of the PPD test are positive, then you are opening the door for further visits from a physician and treatment for a condition. If you have no way of knowing the outcome of the test when you are compiling the medical billing, the …
Critical Care Medical Billing
Critical care is often confusing in the world of medical billing as a number of factors can come into play and whether you need to bundle services or not will also be an issue. Due to the nature of the critical care – notes are often made hurriedly and in many cases are incomplete and it is up to the medical billing professional to put it all together into a package that will be clear, concise and easy to read for the carrier so that the services may be reimbursed. A good example is if a surgeon performed 64 minutes of critical care for a patient in cardiac arrest. During …
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