Archive for the Week of June 2, 2007

Archive for the Week of June 2, 2007

Welcome to the medical billing blog archive for the week of June 2, 2007.

Here you will find links to every article added to the Outsource Management Group web site during the week of June 2, 2007.

You can browse this week's archives by clicking the "More" button from any of the excerpts below.

Medial Dislocation – Billing it Right

A common occurrence in the emergency is the dislocation of various joints. They are sometimes incorrectly handled as breaks but shouldn’t be and you could be setting your practice up for a denial at best and audit at worst if you report these procedures incorrectly on your medical billing. Even if the reduction of the dislocation fails, the attempt should be reported on not only the medical billing as a procedure but also in the documentation as another procedure will have to be tried to relocate the elbow to its proper placement and you can show the timeline for the necessity of other and more involved treatments. On the claim

Ready for the New NCCI Edits Coming in July 2007?

The new edits coming in July 2007 will mainly affect ER room practicioners and physicians and nurses that treat patients in nursing home facilities. These updates will be items you need to know in order to avoid denials and get maximum reimbursements on your medical billing claims. The codes that were changed in the upcoming release were codes 99281-99285 (Emergency department services) are considered component codes of the more global 99304-99306 codes (Initial nursing facility care). This means if a single physician provides a level-two ED service along with a level-two initial nursing home service, you should only report 99305 (Initial nursing facility care, per day, for the evaluation and

Reimbursements Can Be a Reality For Chronic Bronchitis Claims

If your medical billing claims for patients who present and are diagnosed with chronic bronchitis are getting denied payment by the carrier; take a very close look at the code you’re using to report this condition. One of the biggest reasons chronic bronchitis isn’t paid on a claim is because it is reported as a general chronic code using 491.9, Unspecified chronic bronchitis. The trick is to forego choosing the 491.9 as the ICD-9 will lead you to do. Instead look for the diagnosis of the possible cause of the chronic bronchitis such as chronic asthma which has its own specific code. If procedures were performed on the patient, note

Deciding to Use Modifier 59 on Certain Procedures

Sometimes in medical billing it is difficult to decide when to use current procedural terminology codes 58661 and 49322-59. These codes, like many others seem similar, but in actuality, are quite different. When performing medical billing it is necessary to know when to use current procedural terminology code 58661 versus 49322-59. The medical billing code 58661 (laparoscopy, surgical; with removal of adnexal structures) is used when any part of the ovaries or Fallopian tubes are removed. For example, If a surgeon was doing a cystectomy of an ovarian cyst and ended up removing some of the ovary as well, they physician could do medical billing with 58661. The current procedural

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