All Articles Written by Kathryn Disney-Etienne, CCS-P, RT
All Articles Written by Kathryn Etienne, CCS-P - RETIRED
Welcome to the archived list of all medical billing articles written and previously posted to the site by Kathryn Etienne, CCS-P, retired Director of Operations.
All articles are listed below and categorized by date, newest to oldest. Click any article link below to read the entire article.
Medical Billing for Tissue Adhesives
One point that many medical billers find confusing is the correct procedure for coding the use of tissue adhesives when used for wound closures. The answer to this question will be different depending on which entity is paying the medical billing claim. When you code for the use of tissue adhesives, including Dermabond; Medicare has its own guidelines for reporting this procedure that you need to follow to be reimbursed. You should report G0168 for Medicare patients only. If you are reporting the procedure for a non-Medicare patient, you should use the CPT code that is the equivalent and that is 12001-12018 series (Simple repair of superficial wounds …). Another …
Medical Billing Claims for Tests That Are Normal
If you have a medical billing claim to file and the test that was performed on the patient comes back without any definite diagnosis, don’t discount the fact that you won’t be reimbursed for the medical billing, instead you need to determine whether the test result is normal, negative, or inconclusive and that final reading will determine how your medical billing claim should be handled. If your test comes back inconclusive, you shouldn’t report a diagnosis that the laboratory gives you after a pathology test. Many practices mistakenly report the lab’s diagnosis because they feel that claim will legitimately get paid. A good rule of thumb is to code the …
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. …
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 …
Do You Know About the New Mandatory CMS-1500 Form?
Head’s up medical billers, by April 2007, it will be required that you start using the new CMS form that accommodates the new National Provider Identifier (NPI) numbers. “Because of the number and types of changes that the new CMS-1500 includes, you will need to update your billing software programs to print your claims correctly”, says Cyndee Weston, executive director of the American Medical Billing Association. That means now is the time to update your billing system software to ensure your office is ready. If you don’t already outsource your medical billing claims and you don’t want to spend the money for an upgrade – it may be time to …
