Archive for The Month of August, 2006
Archive for the Month of August, 2006
Welcome to the medical billing blog archive for the month of August, 2006.
Here you will find links to every article added to the Outsource Management Group web site during the month of August, 2006.
You can browse this month's archives by clicking the "More" button from any of the excerpts below.
Prior Authorization Can Get More Medical Billing Claims Paid
More and more often, medical billing claims that include saphenous vein ablation are getting very close scrutiny by carriers before reimbursements will be allotted. One of the biggest red flags is that most payers, including Medicare, will only cover payment for a very limited number of specific varicose-vein diagnoses. Samplings of the commonly and correctly reported procedures covered are as follows: * 454.0–Varicose veins of lower extremities; with ulcer* 454.1–… with inflammation* 454.2–… with ulcer and inflammation* 454.8–… with other complications. However, when these are reported correctly, you should have detailed documentation to why the procedure was needed and documentation of the failure of non-surgical treatments that were used previously …
Pregnant Patient Transfer Easy On Your Medical Billing
Pregnancy medical billing is a rather straightforward process. That is, unless the patient transfers practices in the middle of her prenatal care. Pregnancy transfers scare many medical billing personnel, however if you can remember three tips, maternity transfers will be a snap. How you do medical billing for a maternity transfer all depends on how many times she was seen in the clinic. If she was seen 1-3 times you always want to code those visits as evaluation and management visits. One thing to keep in mind is that the first antipartum visit is not as straightforward as you may think. Always keep track of the level of service (level …
Universal Injection Code
As of January 1, 2006; changes were made regarding therapeutic and antibiotic injections medical billing claims that will affect your medical billing claims if you don’t update your filing methods. In the past there were separate injection administration codes for a therapeutic, prophylactic, diagnostic injection and an antibiotic injection. Instead of choosing to report administration of a prophylactic Synagis treatment (90378) with a 90782 (Therapeutic, prophylactic or diagnostic injection , you now simply use 90772 as a universal injection code. On E/M coding, you will generally still need to attach modifier 25 to insure you’re your claim is handled. Modifier 25 states that this procedure or other service was performed …
Can You Bill Medicare – When the Patient Has Died
A confusing medical billing situation can arise when a patient dies en route or shortly after being admitted to a hospital. Many medical billers struggle with what to report or amount of procedures to report that were performed prior to the patient expiring. A good example would be a patient that presented in the ED for CPR direction. The ED physician tells EMS to perform defibrillation and administer medications. When EMS brings the patient into the ED, the doctor examines the patient and decides there isn’t cause to continue CPR and pronounces the patient dead. How should this be reported? Normally, on your medical billing form, you would usually bill …
The Removal of Sutures
Medical billing allows for very little wiggle room in your descriptions and documentation. Almost all surgeries, whether performed in the doctor’s office, or in the operating room have a follow-up period. This means that during that particular 15-day, 30-day, 60-day, etc. period, any treatment the surgeon does for that surgery is included in the medical billing of the surgery itself. However, there is an exception to this rule. An example of an exception to this medical billing rule deals with mentally handicapped patients. The removal of sutures is usually a procedure performed within the postoperative follow-up period. Medical billing is usually done only for the surgery. However, if a mentally …
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