Bundling Claims Brings Higher Ob-Gyn Reimbursements

Bundling Claims Brings Higher Ob-Gyn Reimbursements

Medicare has made several changes to the bundling procedure for Ob-Gyn medical billing. The procedures for bundling codes or not bundling certain current procedural terminology codes when doing medical billing constantly changes for Medicare. In order to receive the highest reimbursement possible, it is necessary to know the correct billing for certain medical current procedural terminology codes.

The latest Medicare change deals with current procedural terminology code 57283 (colpopexy, vaginal; intra-peritoneal approach). You can no longer perform separate billing for this medical code and 57280 (Colpopexy, abdominal approach). They are mutually exclusive. This means that if both codes are reported on the same day in medical billing, only one of them is reimbursable. If both medical billing codes are reported, Medicare has decided to pay for the least expensive code between the two. This is 57283 which costs about $725.

If your medical billing personnel did not know this change and they reported both current procedural terminology codes on the same day, the reimbursement would be lower than expected. To prevent this from happening, only report the most complex code for that day. When using our example, you would do medical billing for code 57280 instead of 57283.

There are several other medical billing codes that have changed as a result of the Medicare amendments. Since these procedures are constantly changing, keeping up with them can be a headache. To prevent this type of stress from entering into your practice, outsourcing your medical billing responsibilities could be an answer. These medical billing firms deal with billing changes every single day. They have the manpower and the software to deal with the changes. To keep your practice running as smoothly as possible, medical billing firms can assist you with bundling procedural changes.

View all Articles by: Melissa Clark, CCS-P