Medical Billing Blog: Section - Audit
Archive of all Articles in the Audit Section
This is the archive containing links to all articles written in the Audit section of our blog.
Click any of the article links below to read the entire article or browse another section to the right to read articles on another subject.
RVUs Made Easy!
RVUs (relative value units) cause a lot of confusion in the medical billing world when you’re dealing with imaging procedures. It’s really just a matter of listing your services rendered logically then tallying them up from largest to smallest. For example, imaging codes aren’t discounted under the multiple-surgery payment reduction, so you typically list surgical codes first, in order by RVU, then the imaging codes. Your final coding report should look like this in order : * 35471 main coding * 36245 main coding * 75722-26-59 procedure with modifier * 75966-26. procedure with modifier Just remember to list the “heavier” codes at the top of your list and the lighter …
Audit Triggers to Watch Out For in 2008
In 2007 the OIG zeroed in on incident to billing claims. The HHS Office of Inspector General plans to issue a report on whether all the requirements for incident-to billing, including direct physician supervision are being followed. The OIG wants to know whether these services met the Medicare standards for medical necessity, documentation and quality of care, according to the OIG’s Work Plan. Other topics include: Other things that will be closely studied in the report include global periods and how they are determined in the medical billing. The agency will also be in the lookout for assignment violations where the physician has billed the patient more than Medicare co-pays …
Getting Place of Service (POS) Codes Right
For correct payment amount, accurate place of service codes are required. The failure to provide the correct place of service code with the correct current procedural terminology code for E/M services will cause your claim to get denied. One of the most important elements of medical billing is the place of service code. In medical billing, the place of service codes for an evaluation and management are commonly misused. There are several current procedural terminology codes for an evaluation and management session that correspond to different medical billing place of service codes. When using CPT 99341 (Home visit for the evaluation and management of a new patient) through 99350 (which …
Taking the Headache Out of Credentialing
Are you swamped? So overwhelmed with patients, billing, invoices, emergencies and other day to day practice worries that you don’t even have the time to get yourself credentialed with all the carriers possible. No one has to tell you that the more insurances you accept, the more patients you can see and the more revenue you can generate for your practice. Credentialing is the key. Did you know your medical billing partner can take some of the heat off you and not only compile and submit your medical billing, they can also get your practice credentialed with any carrier you choose. If you have a busy practice, you may be …
Getting the Indirect Supervision Code Right in Three Steps
For help with performing the care plan oversight services if you are having a hard time with the 993xx series these steps should help to get you started. Step one is to count these care services as 99374-99380. The 993xx series codes allows pediatricians to bill for coordination of care of special needs children without face to face visits. You can report these care plan oversight CPO codes as 99374-99380 for Doctor supervision. This is only for when the patient is not present for the following doctors services, a) revision or development of care plans for multidisciplinary and complex modalities. b) related lab and other studes review c) patient status …
