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.

Keeping Up With Medical Billing Changes

January 2007 brought more changes to the medical billing industry. Certain codes were “retired”, new codes were added and others simply had their meanings broadened to encompass their meanings. If your practice doesn’t keep up with the changes and know in advance of coming changes, you can be losing out on legitimate revenue for services rendered. Some practices are losing up to one fourth of their revenue simply because they staff isn’t aware of the best techniques for reporting procedures. Undercoding is another way many practices don’t get the full value for their services. If your staff is undercoding your medical billing claims you are definitely missing out on reimbursements.

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

Medical Billing To Differentiate Between Facial and Dental Nerve Blocks

When you have a procedure that can cover two close but distinctly different areas such as a facial and a dental nerve block, you need to make sure that your claim encompasses exactly the procedure that was done or you may wind up with a denial of your claim. A common situation would be if the ED physician performed a diagnostic nerve block on a patient complaining of pain in the floor of her mouth and her bottom set of teeth. You would want to be certain that you chose 64402 (Injection, anesthetic agent; facial nerve) for facial nerve blocks, not blocks in the mouth or jaw. The determining factor

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

What About Modifier Q6?

Remember when medical billing used to be a simple affair of matching the procedure done with a couple of medical billing codes to describe what was done, attaching your documentation and then submitting your medical billing claim for reimbursement? Now we have codes for codes and modifiers and the need to when to bundle and when to not bundle with the goal being fair reimbursement for procedures done. Modifiers cause a lot of confusion for many medical billers. One such confusing modifier that is worth clarifying is Q6. This applies to Medicare medical billing claims only, but in a nutshell when one of your staff physicians takes a leave of

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

Correct Coding for Long Term Care Medical Billing Claims

Long term care medical billing has it’s own set of nuances that must be followed in order to ensure that you receive proper reimbursements for the services you provide. Since nearly every patient you treat will have a long term history of care – it’s sometimes tempting to skimp on the medical documentation and necessity but since you have no way of knowing who is going to review your claim, you need to handle every claim as a fully individual manner complete with full documentation or you may wind up with partially paid claims or outright denials of your medical billing claims. One important thing to learn is when you

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

Make the Switch to Outsourcing for 2007

Outsourcing your medical billing claims to a third party partner may be one of the smartest business moves you make in 2007. You may have had every intention of doing your own medical billing for your practice from the day you opened until the day you retired, however with the never ending changes and nuances in medical billing claims varying from cancelled codes to nonpayment of certain procedures because they simply weren’t reported correctly – there comes a time when you need to look at your revenue flow from your reimbursements and decide it might be time to outsource your medical billing claims. Another reason to outsource is the small

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