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.

Gastric Bypass Codings Becoming More Common

As a medical biller, you may be seeing an increase in the number of gastric bypass claims that you are handling as more and more insurances are covering this procedure as a measure to remove the patient from danger of developing more serious, chronic and costly illnesses that can stem from being grossly obese. After a patient has undergone gastric bypass surgery, eventually they will have the band removed. Many medical billing professionals are amiss at whether to include modifier 59 with their claim in order to obtain reimbursement for the procedure. Under The Correct Coding Initiative (CCI), normally the procedure of removing the band and port removal would be

Published By: Melissa Clark, CCS-P | No Comments

Can Your Practice Benefit From the Auditory Rehabilitation Boost?

The Centers for Medicare and Medicaid Services have recently made it known that the reimbursement for procedural code 92696 is going to be increases by a rather large amount. To clarify a little bit further, the reimbursement to providers for such a procedure will come in at approximately four times the amount being received currently. This should make any of the providers of language, speech and hearing much happier when it comes to medical billing. This entire thought of reimbursement may be a lot clearer if it is broken down a bit. For example, the code 92626 which is known for the description of Evaluation of Auditory Rehabilitation Status; first

Published By: Melissa Clark, CCS-P | No Comments

The Sensitive Issue of Handling Hard Copies

A question that comes up often is exactly how should a medical practice dispose of the hard copies of files? The answer isn’t rocket science, shredding is the only good answer. When you are ready to dispose of hard copies medical files, anything with a patient’s name on it should be shredded. If you don’t have the staff available and you don’t want to invest in an industrial-sized shredder, a good alternative would be to hire an outside shredding service that will either come to your offices and shred on site; or pick up your files, lock and store them in sealed containers and put them on a closed end

Published By: Melissa Clark, CCS-P | No Comments

Been Hit With Medically Unlikely Edits Denials?

It can happen to any individual who is involved with coding, dealing with MUEs can end up being a nightmare if you do not know when and how to use them. MUEs, which is short for the term Medically Unlikely Edits, happen to be put in place to try and help limit the amount of billing errors. The more you understand them, the better off you will be when you find that you need to use them. If you are worried about dealing with MUEs, then you really should know that you are not alone. Luckily, there are a couple of things that you can look to and keep in

Published By: Melissa Clark, CCS-P | No Comments

Medial Dislocation – Billing it Right

A common occurrence in the emergency is the dislocation of various joints. They are sometimes incorrectly handled as breaks but shouldn’t be and you could be setting your practice up for a denial at best and audit at worst if you report these procedures incorrectly on your medical billing. Even if the reduction of the dislocation fails, the attempt should be reported on not only the medical billing as a procedure but also in the documentation as another procedure will have to be tried to relocate the elbow to its proper placement and you can show the timeline for the necessity of other and more involved treatments. On the claim

Published By: Kathryn Etienne, CCS-P | No Comments