Archive for The Day of April 5th, 2006

Archive for the Day of April 5th, 2006

Welcome to the medical billing blog archive for the day of April 5th, 2006.

Here you will find links to every article added to the Outsource Management Group web site during April 5th, 2006.

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

Avoid Fraud and Abuse Charges With Careful Gainsharing

Gainsharing may be beneficial for your bottom line in medical billing, but it raises a lot of suspicion for the Centers for Medicare & Medicaid Services. The HHR Office of Inspector General believes gainsharing can be questionable because it can violate anti-kickback policy, and the Stark Law. The Office of Inspector General states there are three fraud safeguards to use when using gainsharing medical billing. First, when utilizing gainsharing arrangements, you should be sure your organization promotes accountability. If you are accountable for your policies and medical billing procedures, you look a lot less suspicious. Another gainsharing safeguard to use is to limit any payment that could change referral patterns.

By: Melissa Clark, CCS-P, RT - CEO
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Correct Diagnosis and Dressing Medical Billing And Coding

The correct medical billing code for attending to surgical sutures is fuzzy. Currently the regional home health intermediary is closely examining the use of the code V58.3 (attention to surgical dressings and sutures). Medical billing constantly changes and the close examination of V58.3 is a perfect example of this statement. The medical billing question is whether or not V58.3 is a suitable primary diagnosis code. The Regional home health intermediary is pulling claims with this diagnosis code and reviewing them for medical necessity. The decision on how to use V58.3 correctly in medical billing will be released once the examination is completed. Since changes to procedures and policies are quite

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