Avoid Fee Reductions in Your Medical Billing

If you have multiple endoscopic services that were rendered during one surgical session, make sure that you determine if the procedures were all part of a “parent” procedure. If that is the case, you can not bill for different endoscopes, you must put them together as one service or you run the risk of having the carrier impose a fee reduction on your medical billing claim.

The parent code must be included in the medical billing and be sure to include your documentation of medical necessity to insure that your medical billing claim gets paid in full and not a reduced reimbursement or worse, an outright rejection. If other endoscopic services were performed and they were not located within range of the parent code, you may report them as separate procedures during the same servicing of the patient.

In the event you do not have a parent code for your endoscopic procedures, you may bill all the procedures as long as separate scopes and places on the body were serviced. Use the CMS fee schedule to quickly break down the parent codes so your medical billing can be as accurate as possible.

If you’re finding the codings and changes are too much to keep up with, consider outsourcing your medical billing to a partner that will not only keep up with the changes, but inform you of coming changes so your staff can always be ready to code for the maximum reimbursements for your practice.

View all Articles by: Melissa Clark, CCS-P