Archive for The Month of September, 2005
Archive for the Month of September, 2005
Welcome to the medical billing blog archive for the month of September, 2005.
Here you will find links to every article added to the Outsource Management Group web site during the month of September, 2005.
You can browse this month's archives by clicking the "More" button from any of the excerpts below.
How Does a CPT Become a Code?
How Does a CPT Become a Code? Some of the most integral components of medical billing are current procedural terminology codes (CPT codes). In order to understand correct coding practices for medical billing, it is important to understand how a CPT code becomes a code. The first step in issuing a code for CPT comes in the form of a suggestion. Medical personnel, physicians, and state associations regularly make suggestions to the American Medial Association. After a staff member from the AMA reviews the suggestion, that staff member determines if the issue has already been addressed or if it is a new one that needs to be resolved for medical …
Medical Billing For Breast Biopsies To Avoid Denials
Medical Billing For Breast Biopsies To Avoid Denials When performing medical billing on a breast biopsy, it is necessary to follow correct protocol. Failure to do so could result in a returned claim or a denial of payment. The key to any question of medical necessity lies in the diagnosis code (ICD-9 code). Many medical billers have gotten into the lazy habit of only using a 3 digit ICD-9 code. This is because the only payer who seemed to care what the diagnosis code was, happened to be Medicare. Now-a-days most payers require an accurate and complete diagnosis in order to pay a claim. If you are doing medical billing …
Reporting the Right HCPCS Codes For Devices
Reporting the Right HCPCS Codes For Devices When doing medical billing it is very important to report the correct HCPCS codes. Failure to do so could result in a returned claim or partial payment. Both of these outcomes are unacceptable for medical billing companies. Businesses cannot run without begin paid. HCPCS stands for Healthcare Common Procedure Coding System. These codes, similar to Current Procedural Terminology codes, report what medical devices are used for health care when doing medical billing. If the hospital submits a claim that supports a device code or two, that hospital is required to report at least one of the HCPCS codes on a medical billing claim. …
When To Use Modifier -91
When To Use Modifier -91 Medical billing has certain nuances that billers should be aware of when submitting claims to insurance companies. One nuance is a modifier. A modifier adds additional information to a current procedural terminology code that the code itself does not present. Modifier 91 is frequently misused when doing medical billing. Modifier 91 is used to report when multiple diagnostic tests are done during the same day. For example: If a patient is rushed into the emergency room and is given a stat glucose test which determines he has hypoglycemia, he will be given glucose gel. Then the emergency staff will need to test him fifteen to …
How Proper Use of 99231 For Medical Billing Claims Can Boost Your Earnings
How Proper Use of 99231 For Medical Billing Claims Can Boost Your Earnings Unsure of the correct medical billing procedures, physicians frequently downcode 99231 for quick payment. There are so many rules and regulations associated with medical billing, physicians tend to downcode whenever there is a questionable decision. A frequent downcode is 99231. Properly billing 99231 can save practices thousands of dollars. There are three codes that are often misused: 99231, 99232, and 99233. 99231 means problem-focused interval history and exam, straightforward or low-complexity medical decision making. 99232 means expanded problem-focused interval history and exam, moderate-complexity medical decision making. 99233 means detailed interval history and exam, high-complexity medical decision making. …
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