Medical Billing Blog: Section - Medicare

Archive of all Articles in the Medicare Section

This is the archive containing links to all articles written in the Medicare 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.

Flu Season is Nearly Upon Us… Medical Coding for Influenza Vaccine

Since Flu season is rapidly approaching, we decided to take a look at the medical codes that are utilized for billing of vaccine shots.   First of all, what exactly is the Flu? Flu is short for Influenza, which is a contagious respiratory disease caused by the Influenza virus. Influenza virus infects the nose, throat, and in a rare condition the lungs. The symptoms can be mild to severe. The most common influenza symptoms include high fever, sore throat, headache, coughing, runny nose, muscle and joint pain, and fatigue (body weakness). This virus generally occurs during the winter months. Influenza is a serious health condition that can lead to pneumonia.

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

CMS adds 85 more Medicare telehealth services and codes

Becker’s Hospital Review posted that CMS issued various regulatory changes on March 30 to further support hospitals’, physicians’ and other healthcare organizations’ capabilities during the COVID-19 pandemic, including expanding Medicare coverage of telehealth visits.  On March 17, the Trump administration announced CMS will temporarily pay clinicians to provide telehealth services for beneficiaries during the pandemic. CMS is now expanding Medicare coverage of 85 additional services provided via telehealth, including emergency department visits and initial nursing facility and discharge visits.  Here are the 85 additional services, and their respective codes, that CMS will cover when provided via telehealth through the duration of the pandemic:  1. 77427: radiation management 2. 90853: group

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

ICD-10 for Substance Abuse & Mental Health Providers

The Substance Abuse and Mental Health Services Administration (SAMHSA) has published a new fact sheet designed to help mental health and substance abuse service providers make the transition to the new International Classification of Diseases, 10th Edition (ICD-10) code sets. ICD-10 will affect all diagnosis and inpatient procedure coding for everyone involved in mental health and substance abuse healthcare under HIPAA. However the change to ICD-10 does not affect CPT coding for outpatient procedures. All services provided for either substance use or mental disorders are subject to HIPAA standards; therefore, all mental health and substance abuse providers must shift to ICD-10 once it becomes effective on October 1st. SAMHSA’s new

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

New HCPCS Medical Billing Tool

Your practice should know where to look for medical billing changes each year. When dealing with HCPCS consolidated billing, many billers become confused about what codes are excluded from this type of billing. Before allowing your staff members to do medical billing, be sure they know where to look for answers to their coding questions. The source to find consolidated HCPCS medical billing codes is no longer in the Centers for Medicare & Medicaid Services’ Skilled Nursing Facility Help File. Since September 25, 2005, CMS has tried to steer medical billing staff members away from this file. Now, however, it is more important to do so. A new website has

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

Update Your Reporting Method To Medicare

Update Your Reporting Method To Medicare or Face Denials Times are changing when performing electronic medical billing to Medicare. Beginning on August 1, 2005, noncompliant electronic claims billed will be denied. These billed medical claims must be compliant with the Health Insurance Portability and Accountability Act (HIPAA). Currently there is a medical billing contingency plan in effect that does accept these noncompliant claims, but that will soon end. In order to ensure the most efficient payment possible, submitting compliant electronic claims is recommended. Otherwise, the Centers for Medicare & Medicaid Services will send the claim back to you unprocessed and with no payment. To get medically reimbursed for this billing,

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