Archive for The Month of March, 2007

Archive for the Month of March, 2007

Welcome to the medical billing blog archive for the month of March, 2007.

Here you will find links to every article added to the Outsource Management Group web site during the month of March, 2007.

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

Are You Guilty of Undercoding?

It’s a dirty little secret in the medical industry that many physicians fail to get the maximum reimbursement on their medical billing claims because they undercode their medical billing claims. Doing this on a frequent basis can cause your practice to lose up to one quarter of your reimbursement revenue. Undercoding also happens because the coding is left up to the staff in the office to perform and this method is guaranteed to have errors and omissions because the staff has no way of knowing exactly which services occurred in the exam room and which did not. Since notes don’t always get made at the time of the procedure, reimbursable

By: Kathryn Etienne, CCS-P, RT - DOO
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Getting Your Moderate Sedation Medical Billing Codes Straight

In late 2006, the CPT added some new codes in their revision. Previously there would have been a need to bill for extra units to capture a procedures base units. With the release of the new moderate sedation codes (99143-99150). The need to bill extra units to capture the procedure’s base unit amounts. Therefore, you should ignore billable units and instead use new time-based codes. A good example would be if a doctor did a procedure that involved 30-minutes of sedation. Previously you would have use 01922 anesthesia designation, you would have used 7 base units and 2 time units (15 minutes = 1 time unit) and you have used

By: Kathryn Etienne, CCS-P, RT - DOO
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Oh, Those Feelings of Rejection!

When your medical billing claims get rejected, one claim can put your staff behind on everything they are supposed to be doing. The patient’s folder will have to be pulled, the notes will have to be re-read and researched, the claim will have to be compiled again and the coding will need to be double checked again to make sure you are using the latest codings and modifiers for the claim. In some cases the carrier will need to be contacted which is more time lost from servicing your practice and the claim will have to be submitted once again and the will take more time away from your day

By: Kathryn Etienne, CCS-P, RT - DOO
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Documenting for Chiropractors and Podiatrists

In 2007, Medicare is going to continue their close scrutiny of chiropractors and podiatrists. The claims submitted by these fields will continue to get looked over due to the extreme amount of fraud that has occurred in these two branches of medicine. Additionally, the stringent guidelines that are currently in place for chiropractors and podiatrists in order to meet payment requirements for certain procedures and debridement services will be getting looked at very closely and continue to be required in order to get their medical billing claims paid. If you perform these services or you are a medical billing company that does claims for these types of practices, check and

By: Kathryn Etienne, CCS-P, RT - DOO
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A Common Reason for Rejection

One way that many medical billing claims get rejected for the smallest of errors. In many cases it can be something as simple as an incorrectly used modifier causing your claim to be rejected by the carrier. There are two modifiers that get a lot of people in to trouble in the form of rejected claims as they can be confusing and those are modifier 25 and 57. Modifier 25 which reads , “Significant, separately identifiable evaluation and management service by the same physician on the same day of the procedure or other service” is kind of a catch all modifier for procedures that may not have an exact coding

By: Kathryn Etienne, CCS-P, RT - DOO
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How Cyber Secure Is Your Medical Billing?

The protection of medical billing personal health information is a priority. Criminals are constantly trying to access the information, while health care professionals try desperately to protect it. Computers and electronics may be a medical billing time saver, but when it comes to security, some practices fall a little short. There are many examples of good practices. A good example is found at The Rehabilitation Institute of Chicago. This facility has recently solved this electronic medical billing security problem with an innovative new system. PostX is the program of choice at the Rehabilitation Institute of Chicago. This is a messaging system that was developed for seamless integration and extremely secure

By: Kathryn Etienne, CCS-P, RT - DOO
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Confused About Flu Shots?

During flu season, flu shots are common in the medical billing world. Like everything else, there are many different flu current procedural terminology codes from which to choose. There are three steps to follow to ensure your flu shot medical billing is completely accurate. The first step is to figure in the age of the patient. Any patient who is age three and above should be given one of two medical billing codes: 90656 or 90658. The medical billing code 90656 stands for: influenza virus vaccine, split, virus, preservative-free, for use in individuals 3 years of age and above, for intramuscularly use. The code 90658 in medical billing means: Influenza

By: Kathryn Etienne, CCS-P, RT - DOO
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Caution When Using Modifier 59 in 2007

Modifiers can be a helpful addition to medical billing. However, there are certain modifiers that are constantly used incorrectly. The contractors for the Centers for Medicare and Medicaid Services are now keeping an eye out for suspicious modifiers. The medical billing modifier 59 is on the list of modifiers to flag for review. Recently, the U.S. Office of Inspector General released a report that showed some daunting medical billing news. Modifier 59 has been the cause of over $59 million in overpayments to nursing homes and providers. Due this large number of overpayments, Medicare contractors will be closely scrutinizing each medical billing submission that contains the modifier 59. Another medical

By: Kathryn Etienne, CCS-P, RT - DOO
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