Archive for the Week of December 22, 2006

Archive for the Week of December 22, 2006

Welcome to the medical billing blog archive for the week of December 22, 2006.

Here you will find links to every article added to the Outsource Management Group web site during the week of December 22, 2006.

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

Wrong Place of Service Can Cause Denials

Check and double check your medical billing claims for the notorious wrong place-of-service (POS) code that can spell denials and delays in getting paid for your observation services. A good general guideline to follow is to use POS 22 (Outpatient hospital) only for observation codes 99217 (Observation care discharge day management …) and 99218-99220 (Initial observation care, per day …). Be sure not to use POS 21 unless the patient has been formally admitted. You will need to split out the time the patient was in observation before they were admitted and use codes 99211-99215 for any E/M services rendered on the second day and before the patient is discharged.

The Three R’s of Medical Billing

If you’re seeing a lot of that other “R” word: rejection; in your medical billing claims – it might be a case of your medical billing claims not meeting the basic requirements for payment. Traditionally, to code a consultation (99241-99255), the encounter had to meet three requirements: *Request for opinion*Rendering of services*Report to the requesting source. Medicare’s new guidelines requires that a physician make the require or other appropriate source for ordering services and procedures. A good way to make sure that there is no denial of the claim, is to have a written reason and request showing a logical progression of the services from the necessity and nature of

Correct Medical Billing for Parent Consultations

The world of pediatric medicine is fast paced and along with unpredictable kids come unpredictable medical billing situations. If you process medical billing for pediatric physicians, you may or may not have run across a situation for determining what diagnoses would apply when parents come in to discuss their child’s health issues. If you’re wondering if there is a single code, the answer is yes. A parent conference falls under V65.19 (Other persons seeking consultation; other person consulting on behalf of another person). In other words, the code describes a person seeking “advice or treatment for non-attending third party.” Since a parent has the right to discuss the treatment and

Do You Report Separate Codes for Separate Excisions?

One daily dilemma that many in the medical billing industry face are when to bundle a claim for services rendered and group like services and when to report them separately. Ultimately you want fair reimbursement for all services rendered to patients and with the fee structures for repayment on medical billing claims, it can be confusing about when exactly to combine and when to split services out as individual procedures. A good example would be if a physician debrides two sites with infected decubiti, technically, it would be two procedures and in most cases could be reported as separate. A good rule of thumb would be to first look at

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