The word "outsourcing" has become a dirty word for many physicians that have been burned by medical billing companies that either outsourced their claims to medical billing companies that use neither secure networks nor adhere to HIPAA regulation in order to maximize their profits; or the outsourcing company just turned out to not be reliable and it wound up costing the practice money to utilize their services.

Don't let a bad experience keep you from partnering with a legitimate medical billing company that can not only help you get your reimbursements faster but also realize great profits by maximizing every single medical billing claim that is filed to make sure that all services and procedures are counted by the carrier and reimbursed.

If you've been hesitant about outsourcing your medical billing because you aren't sure it would actually help your practice or you've been burned; do a little research on your own and ask for references. Ask the medical billing company what they will do for you. OMG will not only help you get the best reimbursements on your medical billing, they will also help you manage your practice by keeping your and your staff informed of coming CPT coding changes that will affect your practice as well as helping keep your patient accounts organized and you can log in and see where a patient's account stands for insurance payments versus out of pocket. This is a very efficient way to run your practice and when you have the extra time due to partnering with a competent medical billing partner, you will finally be able to help your practice really grow!

Labels: audit, consulting, denials, hipaa, injections, mastectomy, medical-billing, medical-coding, medical-data, modifier-51, modifiers, nurses, outsourcing, paper-trail, physician-credentialing, security

B-12 injections are a very common procedure. If you're only receiving partial payments or experiencing rejections of your claims, you may need to tighten up your handling of these claims as the codes and procedures for filing criteria have undergone changes in the past year. To eliminate potential medical billing problems, there are five steps to follow to ensure smooth B-12 reimbursement for your claim.

The first medical billing step is to replace the injection administration codes for the B-12. These codes include the current procedural terminology codes 90782, 90788, and G0351. These medical billing codes were deleted from the 2006 CPT list and should no longer be used. The new policy is to use one CPT for the injection: 90772 (Therapeutic, prophylactic or diagnostic injection; subcutaneous or intramuscularly).

The second step when doing medical billing for B-12 is to make sure a family physician is present during the entire administration. The medical billing CPT 90772 clearly requires direct physician supervision.

Third, it is very important to check on the insurance company’s incident-to policies. The medical billing current procedural terminology code 99211 is usually allowed without direct physician supervision, but the Centers for Medicare and Medicaid Services requires the service to be incident-to.

The fourth medical billing step is important. Since direct supervision is required for the CPT 90772, make sure you make it perfectly clear that there was a physician present. One tip is to create a stamp that clearly states “Physician supervision”, and attach this to your medical billing claims. This way, your medical billing will not be denied for such reasons.

The fifth, and final step to ensure B-12 medical billing reimbursement is to forget CMS issued G codes. The Centers for Medicare and Medicaid Services needed prescription drug codes in 2005, however, there were no CPT codes available at that time. For this reason, G codes were introduced for medical billing purposes. Once the newer CPT codes were introduced -the G codes were no longer valid.

Labels: claims, injections, medical-billing, medical-coding, medical-data, outsourcing

Do you find that you have several questions in regards to injection codes? Well, if you do then you certainly not alone! In order to determine which of the codes apply for certain injection procedures, you can use a couple of great guidelines that are sure to help you out.

Perhaps you have a question on whether or not supervision plays a role in the code that you need to report. Is the physician for the patient in the office and available while the injection is going to be taking place? When the answer to this is yes, you can feel confident in reporting code 90772. A code of 9921 should be reported instead when you find that the physician is not available and direct-supervision criteria cannot be met at that time. Basically, in order for the code 90772 to be valid, the physician must be present within the office and available to the patient should the need arise.

In addition to this, when you are coding with 90772, you need to make sure that there is proper documentation in place to support this code entry. If you cannot provide the proper documentation to prove that the physician was there in the office at the time, it is generally known that the code for a nurse visit will be a better option. It is also important that along with the time and nature of the IM injections that the name of the obstetrician in the office at the time be recorded.

Labels: injections, medical-coding