Medicare No Longer Filling in Blank Forms

Previously, when claims came in with incorrect ICD-9 medical billing, the Medicare carriers would make the proper corrections and then reimburse. They would correct diagnosis codes and fill in the blanks if they were empty. This was lazy medical billing on the part of the provider. Now Medicare personnel will no longer do that. They now require correct medical billing in order to reimburse for Medicare part B services.

If a claim is sent in by a diagnostic center, this center must use the diagnosis code given by the referring physician for medical billing. If, for some reason, the physician does not provide a diagnosis, the personnel at the diagnostic centers can select a code based on the medical notes. Medicare will no longer be helping these folks out with their medical billings either.

It is absolutely absurd that claims were being submitted to the Centers for Medicare & Medicaid Services without simple information such as a diagnosis code. Getting reimbursed for medical services means that practices must take responsibility for getting the coding correct and if you find you are at the point your practice is too busy, it might be time to consider outsourcing.

Medical billing firms can eliminate this problem. They have special computer systems that scan claims before they are sent to insurance companies. These computer systems check for errors and omissions so they do not occur. Medical billing firms will keep your practice up-to-date on current ICD-9 changes.

View all Articles by: Melissa Clark, CCS-P