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New Medical Billing Updates

New Medical Billing Updates

New Medical Billing Updates

New medical billing changes grace the therapy scene once again. Medicare part A services for therapy were recently implemented on February 06, 2006. The associated hospital services (AHS) released guideline explanations to help Providers understand the new therapy changes. The AHS is a Hospice and Home Health Intermediary for Medicare. If your practice handles therapy issues, pay attention to these medical billing changes.

In therapy medical billing there are modifiers (GP, GO, and GN), revenue codes (42X, 43X, and 44X), and wound care service CPT codes (97602, 97605, 97606, 97597, and 97598). Of the modifiers and codes listed , providers of the outpatient perspective payment system cannot report these therapy modifiers or revenue codes when wound care services are not performed by a therapist. Also, providers should do medical billing under the outpatient perspective payment system instead of the therapy plan of care.

Another medical billing change to therapy is the need for therapy modifiers on claims performed by non-physician practitioners, and physicians. These types of providers must do something else on the medical billing claims. If they perform services that are considered “sometimes therapy,” they must append with therapy modifiers. “Sometimes Therapy” medical billing codes include 97602,97605, 97606, 97597, and 97598.

Keep your eyes peeled and your ears open for new therapy medical billing changes in the future. These last twelve months have been up and down in the therapy world. Be sure your medical billing staff can adapt to new changes quickly. Adaptability is key in the medical billing industry. Ongoing training and constant practice will keep your physicians , your customer service representatives, and your medical billing staff in good shape. These new therapy changes will, more than likely, not be the last. Medical billing will always change, but your ability to adapt should never change.

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