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.

RVUs Made Easy!

RVUs (relative value units) cause a lot of confusion in the medical billing world when you’re dealing with imaging procedures. It’s really just a matter of listing your services rendered logically then tallying them up from largest to smallest. For example, imaging codes aren’t discounted under the multiple-surgery payment reduction, so you typically list surgical codes first, in order by RVU, then the imaging codes. Your final coding report should look like this in order : * 35471 main coding * 36245 main coding * 75722-26-59 procedure with modifier * 75966-26. procedure with modifier Just remember to list the “heavier” codes at the top of your list and the lighter

Published By: Melissa Clark, CCS-P | No Comments

Audit Triggers to Watch Out For in 2008

In 2007 the OIG zeroed in on incident to billing claims. The HHS Office of Inspector General plans to issue a report on whether all the requirements for incident-to billing, including direct physician supervision are being followed. The OIG wants to know whether these services met the Medicare standards for medical necessity, documentation and quality of care, according to the OIG’s Work Plan. Other topics include: Other things that will be closely studied in the report include global periods and how they are determined in the medical billing. The agency will also be in the lookout for assignment violations where the physician has billed the patient more than Medicare co-pays

Published By: Melissa Clark, CCS-P | No Comments

To Bundle or Not to Bundle?

Critical Care Medical Billing Critical care is often confusing in the world of medical billing as a number of factors can come into play and whether you need to bundle services or not will also be an issue. Due to the nature of the critical care – notes are often made hurriedly and in many cases are incomplete and it is up to the medical billing professional to put it all together into a package that will be clear, concise and easy to read for the carrier to the services may be reimbursed. A good example is if a surgeon performed 64 minutes of critical care for a patient in

Published By: Melissa Clark, CCS-P | No Comments

Medicare Website Updated to Make Medical Billing Information Easier, Faster to Find

Due to high usage and informational usage by the medical billing community at large, the Medicare website has revamped certain areas to make their site easier to search and access. When a medical biller is looking up information, at the Medicare coverage site located at www.cms.hhs.gov/mcd/search.asp, it is now easier than ever to search for the coverage limitations and other required information that you need. The page is now set up to ask if the biller is asking for a local or national coverage determination to avoid confusion and misinformation that was previously disseminated as there are certain differences between local and national coverages for certain procedures. Medical billers may

Published By: Melissa Clark, CCS-P | No Comments

Are You Getting Maximum Reimbursements for ER Dislocation Procedures?

A common occurrence in the emergency is the dislocation of various joints. They are sometimes incorrectly handled as breaks but shouldn’t be and you could be setting your practice up for a denial at best and audit at worst if you report these procedures incorrectly on your medical billing. Even if the reduction of the dislocation fails, the attempt should be reported on not only the medical billing as a procedure but also in the documentation as another procedure will have to be tried to relocate the elbow to its proper placement and you can show the timeline for the necessity of other and more involved treatments. On the claim

Published By: Melissa Clark, CCS-P | No Comments