Archive for The Month of November, 2005

Archive for the Month of November, 2005

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

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

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

Reimbursement For Critical Care Medical Billing Codes

Get Full Reimbursements For Critical Care Medical Billing Codes When performing medical billing for critical care services, much accuracy must be followed. It may not be the most important thing on a physician’s mind when a critical patient comes into the emergency room, but medical billing elements cannot be overlooked. There are two elements that are imperative for critical care medical billing: time and medical necessity. In order to use the codes 99291 or 99292 (Critical care, evaluation and management of the critically ill or critically injured patient; first 30-74 minutes and each additional 30 minutes), the patient must have a critical illness or injury. Critical is defined as having

By: Melissa Clark, CCS-P, RT - CEO
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Eliminating SSNs in Medical Billing

Eliminating SSNs in Medical Billing The Durbin amendment will make medical billing safer for senior citizens in the United States. The Durbin amendment makes it mandatory for the federal government to remove social security numbers from all Medicare documents and replace them with a different patient identifier. Since senior citizens are a large target of identity theft, this medical billing change is definitely one for the better. Beginning in 2006, the federal government has gotten on the same page as many states of the nation. Identity theft is so prevalent in the United States and social security numbers make identity theft easy. This means that all senior citizens with Medicare

By: Melissa Clark, CCS-P, RT - CEO
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Overstated Payment Amounts In Medical Billing

Watch Overstated Payment Amounts In Your Medical Billing The state of Indiana is raising some eyes in the medical billing world. The Centers for Medicare & Medicaid Services have strict regulations for payments and upper payment limits (UPLs). Apparently Indiana significantly overstated these amounts, which led to large over payments. Now, the Indiana medical billing overstatements may affect their bottom line. The Office of Inspector General announced that for the Indiana state fiscal years 2001 and 2002, they overstated upper payment limits by about $6.5 million. The medical billing in 2001 was overstated by $2.2 million, and 2002 medical billing was overstated by $4.3 million. The reason these medical billing

By: Melissa Clark, CCS-P, RT - CEO
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Four Coding Myths That Will Cost You

Four Coding Myths That Will Cost You Ob-Gyn coding is a serious medical billing issue. There are many assumptions and myths that billers make when filing claims. Assumptions can cost your practice a lot of money. There are four myths in Ob-Gyn medical billing you should forget. 1st MythIt is incorrect to bill separately for the initial blood work with a nurse and also the initial ob-gyn visit. If blood work is being done, that should be included in the initial visit code, or the global package in medical billing. If your practice has been billing separately for these services, you may eventually need to repay overpayments. 2nd MythAnother myth

By: Melissa Clark, CCS-P, RT - CEO
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Proper use of 90782 billing code

Proper use of 90782 billing code Like any other medical billing code, there is an appropriate time to use the current procedural terminology code 90782. Some people wonder if this code is appropriate when doing medical billing for a tetanus toxoid injection in the emergency room. In medical billing, the best CPT code is the code that most accurately describes the service. In the emergency room scenario, it would not be appropriate to do medical billing for a 90782 (Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscularly) for a tetanus shot. In the emergency room, it would be very difficult to prove it medically necessary for a physician to administer

By: Melissa Clark, CCS-P, RT - CEO
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Do You Know Your Medical Billing RUG’s?

Do You Know Your Medical Billing RUG’s? The New RUG III should bring added reimbursement to freestanding facility medical billing across the country. These new changes will boost payment between 2.4% and 2.9% if the facility handles medical billing correctly. If medical billing is handled incorrectly, a drop in payments could be seen for skilled nursing. Training is of the utmost importance coming up on the new year. If a facility has rehab residents with cushioned care with add-on payments, the RUGs will throw them into a lower paying bracket. Understanding the Medicare per diem levels will be very important when it comes to reimbursement for services. There are several

By: Melissa Clark, CCS-P, RT - CEO
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Medical Billing For Lower Extremity MRIs

Medical Billing Reimbursements For Lower Extremity MRIs Medical billing hip MRI rules are not as straightforward as you might assume. There are many variations on how to correcting bill for this service. There are some facts you should keep in mind when doing medical billing for lower extremity MRIs. Unfortunately, there is no specific medical billing CPT code for an MRI of the hip. You need to use the codes 73721-73723 (Magnetic resonance imaging, any joint of lower extremity). The hip joint falls into this medical billing category because it is a lower extremity joint. Doing medical billing for bilateral hip MRIs is also a bit more complicated. Different payers

By: Melissa Clark, CCS-P, RT - CEO
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Correct Coding For ADD Follow-up Visits

Correct Coding For ADD Follow-up Visits Since attention deficit disorder is so prevalent, medical billing knowledge must also be. ADD walks a thin line between mental health coverage and medical coverage to many payers. To get reimbursed correctly for ADD follow-up visits, correct medical billing is necessary. There are two types of medical billing codes to use for ADD follow-up visits: mental health codes, and evaluation/management codes. 90862 (Pharmacologic management, including prescription, use, and review of medication with no more than minimal medical psychotherapy) is the mental health code. Many insurance companies will deny this medical billing if your physician is not a mental health provider. The evaluation and management

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