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.
ADD/ADHD Medical Billing Reimbursements
Attention providers, are you getting reimbursed for your medical billing ADD medication rechecks? With the rise of ADD/ADHD in America, it is very important to medical practices to understand how to get paid. When dealing with mental health diagnoses, you walk a fine line with most insurance companies. There is one way most payers will reimburse your ADD/ADHD medical billing. Most physicians like to code ADD medication rechecks with the 90862 medical billing code. This code means, pharmacologic management, including prescription, use, and review of medication with no more than minimal medical psychotherapy. Although there is no problem using this CPT code with the diagnosis 314. (Hyperkinetic syndrome of childhood), …
Medical Billing Codes 70551-70553
Using Medical Billing Codes 70551-70553 for MRI and IAC Properly There are many times in medical billing when a patient receives both an IAC and brain MRI. The question is, can the medical biller be reimbursed for both of these services separately? If the medical billing personnel asked the American Medical Association this question, the answer would be simple. They would say that you can absolutely get separately reimbursed for an IAC and brain MRI in the same session. Realistically, however, this is not exactly true. The requirement to code for both x-rays is that they need two separate and distinct exams. Each exam is required to have distinct findings. …
Medical Billing and EOB
Medical Billing and EOB The goal of any medical billing firm is to receive a correct check and correct explanation of benefits (EOB) from an insurance company. Sometimes this is easier said then done. Many times the EOB goes one place and the check goes another. What is the easiest and most productive method for posting payments for medical billing? The first method is an example of a practice that does their own medical billing. In this case, it is beneficial to make sure a check and EOB are sent to the practice and a duplicate is sent to the patient. This prevents future problems with remainders owed. It also …
What is a Late Bill Override Date?
A term you will hear from time to time, especially if your practice is still filing your own claims and you haven’t outsourced your medical billing yet, is LBOD. LBOD stands for Late Bill Override Date and it’s fairly cut and dried. Basically the provider uses the LBOD to document compliance with timely filing requirements which insures that you get reimbursed for services rendered. Generally, you should only use the LBOD if you are filing a claim with dates of service older than 120 days and you must have all documentation on file for these addendums to your medical billing claims. The LBOD is permissible to use on either paper …
Using 92552 Correctly To Avoid Fraud Charges
Using 92552 Correctly To Avoid Fraud Charges Medical billing companies for audiology practices have long struggled over when to use the cpt codes 92552 versus 92551. 92551 means: screening test, pure tone, air only. 92552 means, pure tone audiometry (threshold); air only. You may be thinking, “What’s the difference?”. By definition, the difference between the two cpt codes is slight, but when medically billing these codes, it is huge. To avoid fraudulent charges, correct billing of 92552 is necessary. First we will begin with what it means to use 92551 in medical billing. Simply put, an audiologist places headphones on a patient. Then the doctor sets the machine at a …
