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.
Coding Chronic Pain Syndrome
“Chronic pain syndrome” can be considered as a vague description of a vague diagnosis by your carrier and unless you back up your medical billing with the reasons for using this catchall term for several pain conditions, you may be seeing only partial reimbursements to denials for this condition. Traditionally, ICD-9 directs you to code 338.4 (Chronic pain syndrome) for the condition. However, you may need to couple this diagnosis with other probable causes backed up by symptoms and doctor’s notes. Other diagnosis possibilities for chronic pain syndrome include fibromyalgia/muscular pain (729.1, Myalgia and myositis, unspecified); reflex sympathetic dystrophy/regional pain syndrome (337.2x, Reflex sympathetic dystrophy) or peripheral neuropathy (337.0, Idiopathic …
Are Your E-Transmissions HIPAA Compliant?
If you haven’t taken the time to evaluate your data; both the data that you actively send as well as the data at rest. If you don’t you could be in violation of the new HIPAA violations. The last security rule made by HIPAA (and while the final ruling does not mandate that you encrypt all of your email transmission)it does require that you examine how all of your data is transferred on an overall scale. There are two key items that will help you evaluate how your data is transmitted. (1)integrity controls and (2)encryption. Integrity control sounds a little confusing, but it really just means proper access controls and …
Using Q Modifiers on Foot Care Claims
Make sure that you and your staff are up to date on using Q Modifiers as these were updated in 2007. Make sure you are getting the best reimbursements by using the currently preferred modifiers to be reported when the physician is performing foot care. Modifiers Q7 (One class A finding), Q8 (Two class B findings) or Q9 (One class B and two class C findings) tell insurers why your physician is performing foot care. To determine which modifier applies to your physician’s claim, check out the following list of what Medicare and other payers include in each description: Class A Finding:Nontraumatic amputation of foot or integral skeletal portion thereof …
Are You Reporting Circumcision With Nerve Blocks Correctly?
There are some new guidelines for reporting a nerve block with a circumcision. In the past you may have reported this as two separate procedures using 54150 to document the circumcision and 64450 for the accompanying nerve block. However the AMA has revised code 54150 (Circumcision, using clamp or other device with regional dorsal penile or ring block) in the new edition of CPT 2007 to include the accompanying nerve block in the description of the service. As such, it would now be unnecessary to report 64450 (Injection, anesthetic agent; other peripheral nerve or branch) with 54150 for this purpose, and the National Correct Coding Initiative (NCCI) bundles 64450 into …
Tips for Handling Critical Care Evaluation for Pediatric Medical Billing Claims
Pediatrics is one of the most complex areas of medical billing. It has many medical billing codes that were created just for the use of describing procedures. However, there are other areas of medical billing that do not have these specific codes for children. This can make coding hit or miss unless you know the nuances of what the carrier wants in order to get the maximum reimbursements for procedures performed. A common dilemma is with CPT code 99293 and its use for outpatient emergency room exams for an infant or if code 99291 should be used. The medical billing code 99291 means critical care, evaluation and management of the …
