Medical Billing Blog: Section - Medical Billing
Archive of all Articles in the Medical Billing Section
This is the archive containing links to all articles written in the Medical Billing 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.
When New Billing Codes Aren’t Recognized
In medical billing, code recognition is not the only reason for denial. If a claim containing a new code is denied, go through your medical billing claim and make sure it is absolutely accurate. Then you can probably narrow down the reason to simply a matter of the carrier not recognizing the CPT code. When new medical billing codes are introduced there is a lag period that lets coders and payers get adjusted for that specific code. HIPPAA sets an effective date for all medical billing codes that states when companies must begin using the codes or accepting the new codes. It is illegal to deny claims for no recognition …
The 4 Big Myths of OB-Gyn Medical Billing
OB-Gyn medical billing can be very confusing and some physcians will under code their medical billing claims as they fear an audit so they don’t submit full claims but in fact, this practice will cost you money. In order to understand OB-Gyn billing fully, you must understand the myths associated. There are four medical billing myths associated with OB-Gyn medical billing that may be holding back your reimbursements. The first myth deals with the initiation of the ob record. If both the ob-gyn and the nurse see the patient for initial blood work, you should not report a minimal code for both instances. In OB medical billing, you should report …
Making Inpatient Reporting Easy
One of the most difficult medical billing feats is inpatient consultation coding. There are many instances when a follow-up inpatient consult should be replaced by a subsequent hospital care visit. To eliminate these medical billing errors, there are four facts to consider when coding for inpatient consults. The first fact is very obvious. If your report an inpatient consultation exam, the patient must be inpatient, not outpatient. Very often physicians see patients on a consultation basis when they are outpatient. Medical billing mistakes can be made easily. Double check your work. It is important in medical billing to always report one initial consultation. This code will correspond with the very …
Better Medical Billing For MRI Claims
Medical billing hip MRI rules are not as straightforward as you might assume. There are many variations on how to correcting bill for this service. There are some facts you should keep in mind when doing medical billing for lower extremity MRIs. Unfortunately, there is no specific medical billing CPT code for an MRI of the hip. You need to use the codes 73721-73723 (Magnetic resonance imaging, any joint of lower extremity). The hip joint falls into this medical billing category because it is a lower extremity joint. Doing medical billing for bilateral hip MRIs is also a bit more complicated. Different payers require different modifiers for payment. For example, …
Medical Billing Once or Twice for Certain Codes
Patient evaluation codings can be very confusing. The patient initial evaluation code is 97001 (also, 97003, 92506, 92610) however if the patient is reevaluated (97002- patient reevaluation) within a 12 month period only one unit of service may be billed to Medicare Part B patients no matter how much time was spent actually servicing the patient. If you make a mistake and bill the carrier for the evaluation and a unit of service for the reevaluation, your claim will be denied based on incorrect coding no matter how much medical documentation you provide showing the necessity of the reevaluation of the patient. Keeping up with the fast paced changes of …
Don’t Make a Bad Choice With a Medical Billing Partner
When you’re considering outsourcing your medical billing from your practice to a third party partner, it pays to look around and find the best fit for the needs of your individual practice. Be aware that the best choice may not be around the corner or even in the same state as your practice. With the security of Internet transmissions, you can use a company across the country and be just as secure as if you were handing your documentation directly to someone across the hall from you. Making the choice to use a medical billing company for your practice can save plenty of money. However, choosing the wrong medical billing …
Medical Billing – Beginning With the Basics
It starts with a patient who sees a physician. The patient gives the office their insurance or Medicare card and a new medical billing form is generated. No matter what procedures are rendered to the patient, it will be documented in the form of numbers called CPT codes, on the medical billing form. If the patient has any testing done such as a blood or urine sample, basic evaluation or even a patient history interview, all of this including if the patient is a first time visit or not will be documented on the medical billing form. If there is a reason for the patient not feeling well such as …
Switching to Outsourcing Made Painless
Most practices start out very small and usually with just a doctor and one other person. Between yourself and the other person, you answer phones, greet patients and grow your practice and soon you may find that you need help keeping up with your medical billing claims. Many doctors start expanding their staff at this point, hiring assistants and office personnel to handle the additional workload that happens as the practice continues to grow. And then new fees are added to your overhead in the form of additional salaries to pay, unemployment and state and federal taxes. This is when many physicians begin thinking about outsourcing and for the majority …
Revisiting Modifiers 25 and 57
If you have a number of medical billing claims getting rejected, once you rule out any larger reasons, you might start looking for the key in the use of; or rather the lack of not using modifiers as a part of your medical billing claims. Two of the main modifiers that get people in trouble with their medical billing claims in the forms of rejections are modifiers 25 and 57. Modifier 25 reads , “Significant, separately identifiable evaluation and management service by the same physician on the same day of the procedure or other service” is kind of a catch all modifier for procedures that may not have an exact …
Outsourcing Makes Reimbursements Happen Faster
Think about it, would you ever think that sending your medical billing claims outside of your office could actually get them paid quicker? It doesn’t sound logical at first glace, but it’s very true the outsourcing your medical billing claims will usually get them paid faster. Think about how often your in-house staff gets interrupted, how often the crisis of the moment rears its ugly head and day to day managing of the office prevents them from filing, double checking accuracy, and following up on your submitted claims. Time is also lost re-submitting claims when they get kicked back for the smallest of errors in coding. As you know, Medicare …
