Archive for The Month of October, 2005

Archive for the Month of October, 2005

Welcome to the medical billing blog archive for the month of October, 2005.

Here you will find links to every article added to the Outsource Management Group web site during the month of October, 2005.

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

The Right Medical Billing Code For Home Dialysis

Using The Right Medical Billing Code For Home Dialysis A simple, but crucial medical billing change has recently occurred. Beginning on October 1, 2005, the Medicare durable medical equipment regional carrier (DMERC) will no longer accept the diagnosis code 585.0. Instead of using ICD-9 585.0, medical billing should be done with the ICD-9 code 585.6 for home dialysis charges. The code 585.0 means chronic renal failure. This code has now been discontinued and the DMERC will no longer be lenient on the code. The more descriptive code, 585.6 (end stage renal disease) much more accurately describes the diagnosis for home dialysis. It is important that your medical billing staff note

By: Melissa Clark, CCS-P, RT - CEO
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Using V58.3 Correctly In Your Medical Billing

Using V58.3 Correctly In Your Medical Billing Using code V58.3 in medical billing should be used with care. Beginning on October 6, 2005 the Regional home health intermediary conducted a review of all claims submitted with this code. V58.3 means attention to surgical dressings and sutures. Soon this medical billing code will be closely scrutinized for medical necessity. Now a days, the Centers for Medicare & Medicaid Services closely examines each and every claim that comes through their department. Over billing and fraud have become so prevalent, that they must keep a close eye on these medical billing practices. One of the codes they have decided to crack down on

By: Melissa Clark, CCS-P, RT - CEO
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Using The 3-Year Rule In Your Medical Billing

Using The 3-Year Rule In Your Medical Billing Did you know that the medical billing rule states that your patient is new if you haven’t seen them for three years? There are usually several questions people have about how to code a semi-established patient. There are some simple medical billing tips to keep in mind when performing this task. It is a common medical billing mistake to bill for a new patient visit when the patient is merely visiting a different doctor in the same medical practice. The rule states that if you are using the same provider code, then you are considered one entity. Even if the time spent

By: Melissa Clark, CCS-P, RT - CEO
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Simplify Pregnant Patient Transfer On Your Billing

Simplify Pregnant Patient Transfer On Your Medical Billing Pregnancy medical billing is a fairly straight forward process. That is, unless the patient transfers practices in the middle of her prenatal care. Pregnancy transfers scare many medical billing personnel, however if you can remember three tips, maternity transfers will be a snap. How you do medical billing for a maternity transfer all depends on how many times she was seen in the clinic. If she was seen 1-3 times you always want to code those visits as evaluation and management visits. One thing to keep in mind is that the first antipartum visit is not as straight forward as you may

By: Melissa Clark, CCS-P, RT - CEO
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Hospital Discharge – A Commonly Misbilled Service

Medical Billing – A Commonly Misbilled Service Many people believe medical billing can be a pain, but in some instances correct medical billing can bring you additional money. A commonly missbilled service is the professional fee for a hospital discharge. There are many medical billing mistakes made with this service. People bill for the discharge when they are not supposed to, and then don’t bill when they are entitled reimbursement. Medical billing personnel also tend to bill an incorrect CPT code when they do bill for hospital discharge. This hospital discharge medical billing mess needs to get straightened out! First of all, many times physicians should not bill separately for

By: Melissa Clark, CCS-P, RT - CEO
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Avoid Medicare Investigations On Medical Billing

Avoid Medicare Investigations Over Your Medical Billing Sending in medical billing claims to any government organization can be nerve racking, especially when submitting to Medicare. Medicare will do an audit on your claims if you show suspicious charges or activity that does not match your FACP. There is one main thing you can do to prevent this medical billing audit: provide adequate records. The Centers for Medicare & Medicaid Services is very hesitant to pay more administrative costs then you claim on your FACP. This is one organization in which you will probably not make any profit. It is important that your FACP report closely matches the Medicare charges you

By: Melissa Clark, CCS-P, RT - CEO
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Medicare Paid Out $900 million In False DME Claims

Medicare Paid Out $900 million In False DME Claims Large fraudulent medical billing claims are making the senate the Government Accountability Office antsy. Charles Grassley recently sent a letter to the Centers for Medicare & Medicaid Services with a daunting reality. CMS wasted $900 million dollars in incorrect durable medical equipment in 2004. For the survival of Medicare something has to change. This fraudulent medical billing needs to be taken care of. Apparently the 2004 incorrect medical billing dealt with orthotics, equipment, and prosthetics. It seems that the Centers for Medicare & Medicaid services did not keep a closer eye on their National Supplier Clearinghouse. This contractor’s job was to

By: Melissa Clark, CCS-P, RT - CEO
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When Medicare Computer Glitches Eat Your Claims

Medical Billing Dilemma – When Medicare Computer Glitches Eat Your Claims Keep your eyes peeled for medical billing mistakes coming from the Centers for Medicare & Medicaid Services. Medicare Part B carriers are changing software systems over to the Multi-Carrier System. Some carriers have already switched to the system, some are in the process of switching, and some will change in the near future. This medical billing switch has created a lot of needless headache for providers. During the Centers for Medicare & Medicaid Services software switch, there have been many medical billing claim errors. Errors that have occurred or could possibly occur in the future include: missing updated codes,

By: Melissa Clark, CCS-P, RT - CEO
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