Medical Billing Blog: Section - Claims

Archive of all Articles in the Claims Section

This is the archive containing links to all articles written in the Claims 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.

Is Your Small Practice Ready for ICD-10?

It’s 193 days to ICD-10 and to be honest, that’s not much time! It’s time to get your practice ready to use ICD-10, but where do you begin? There’s no question it can be overwhelming! Here’s the steps we recommend to any Providers that ask. Let’s get started. Put One Person in Charge First things first, you need to assign the task of overseeing ICD-10 to someone on your staff. It doesn’t matter whether that person is the biller, a coder, the office manager, or someone else. Their goal is to lead the process, ensure things are on task and on target, and to oversee the details.   Develop a

By: Kathryn Disney-Etienne, CCS-P, RT - Director of Operations
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Demonstrating the Complexity of Care

SCENARIO: So, you are working at a multi-specialty practice that recently employed a urologist. As the Lead Medical Auditor and a member of the Corporate Compliance Team, you begin to worry about the chart audits as you have no members on your team that have worked within this specialty before. Take a deep breath – and remember that the largest volume of claims that the urologist will bill are E&M services. Regardless of the specialty of any medical practice, each will utilize Evaluation and Management (E&M) services in greater volumes than surgical services. Specialty-specific trained medical auditors are well versed in trudging through records to note the disease processes and

Guest Article By: Shannon DeConda
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EHR Meaningful Use and Stage 2 Guidelines

January has brought upon the EHR (electronic health records) Stage 2 incentive programs start for physician and medical practices. However, there is a great deal of concern that those doctors who can meet Stage 1 requirements will not be able to meet the Stage 2, because their EHRs are not up to standard and neither are the vendors that they deal with. There are 2200 products and almost 1400 EHR certifications for Stage 1, but only 75 products and 21 EHR certifications for stage 2. Around 90 percent of the vendors are expected to not be ready for stage 2. Stage 2 is the second step of meaningful use for

By: Melissa Clark, CCS-P, RT - CEO
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ICD-10 Preparation Steps and Tips for Medical Providers

As a Provider, ICD-10 preparation, and the subsequent upcoming transition can be a bit daunting. The first thing I recommend you do is to assign one individual to be the driving force behind the process and to oversee the details. This could be your coder, office manager, biller or anyone in your staff with the drive to make it as smooth as possible. Next, you should begin to develop your timeline. It’s important for you to have goals in place so that you can achieve your plan. One of the key elements you will need to do in your preparation is to identify the most common codes that your practice

By: Melissa Clark, CCS-P, RT - CEO
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Pediatric Patient History – Who Can Take It?

Contrary to popular belief, it is safe practice to allow any office member to take the review of systems and the family social history. These two evaluation and management history elements can actually be taken by absolutely anyone. It is ok in medical billing for a parent or a secretary to take down this information as long as the information is reviewed and signed off on by the acting pediatrician. The only part of an evaluation and management visit that the physician or nurse practitioner must complete for medical billing purposes is the history of present illness or the reason for the visit. By allowing your administrative staff to complete

By: Kathryn Disney-Etienne, CCS-P, RT - Director of Operations
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Surefire Tips to Identify Wound Repair Level

Wound repair causes a lot of confusion among medical billers and medical coders. It’s not always easy to identify the level of wound repair involved when reading an operative report. If you cannot quickly ascertain the level of wound repair, then you need to check for a few things. In order to identify wound repair level, you should look to the operative report for these key words and clues: -If a surgeon mentions single layer closure in his or her operative report, it is a simple repair. Simple repairs involve superficial wounds that involve “primarily epidermis, or dermis or subcutaneous tissues without significant involvement of deeper structures” according to the

By: Kathryn Disney-Etienne, CCS-P, RT - Director of Operations
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