Medical Billing Blog: Section - Modifiers
Archive of all Articles in the Modifiers Section
This is the archive containing links to all articles written in the Modifiers 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.
Medical Billing Services Free Your Staff
If your staff is stretched to the limits handling patients and day to day business matters in your practice, it might be time to consider outsourcing your medical billing claims. When you outsource, your claims can become seamless and you will lose the hassles of keeping up with the latest criteria in coding and the paper chase of your medical billing is effectively over. Simply by outsourcing your medical billing claims, you can leave so many of the irritating and sometimes time consuming processes that are required to file your medical billing claims. Not only can your medical billing partner file your claims,they will follow up on those claims too. …
Ending Confusion on Multiple Procedures
When you have a patient that has had multiple procedures performed, make sure that the group of procedures that were performed actually require modified 51 before you attach it. The CPT has a list of certain coding that are exempt from modifier 51. The CPT manual designates modifier 51 (Multiple procedures) exempt codes with a “circle with a slash” symbol to the left of the code for the services rendered. There is usually a complete listing of modifier 51 exempt codes in an appendix. The list is “a summary of CPT codes that are exempt from the use of modifier 51 but have NOT been designated as CPT add-on procedures/services,” …
Breaking Down a Breast Biopsy
Here is a perplexing problem. When a surgeon meets with a patient an recommends a breast biopsy, we report a consult for this particular visit. On the day of the biopsy procedure, the surgeon will re-examine the patient, answer questions, an so on. The time that is spent prior to the procedure is ten minutes. In a case like this, you will not report a separate E/M with the biopsy. It is important to remember that all procedures include an inherent E/M component, according to CPT and CMS guidelines. In order to qualify as a separately billable service, any E/M the physician provides must be both signifigant and separately identifiable …
Getting Your Moderate Sedation Medical Billing Codes Straight
In late 2006, the CPT added some new codes in their revision. Previously there would have been a need to bill for extra units to capture a procedures base units. With the release of the new moderate sedation codes (99143-99150). The need to bill extra units to capture the procedure’s base unit amounts. Therefore, you should ignore billable units and instead use new time-based codes. A good example would be if a doctor did a procedure that involved 30-minutes of sedation. Previously you would have use 01922 anesthesia designation, you would have used 7 base units and 2 time units (15 minutes = 1 time unit) and you have used …
Oh, Those Feelings of Rejection!
When your medical billing claims get rejected, one claim can put your staff behind on everything they are supposed to be doing. The patient’s folder will have to be pulled, the notes will have to be re-read and researched, the claim will have to be compiled again and the coding will need to be double checked again to make sure you are using the latest codings and modifiers for the claim. In some cases the carrier will need to be contacted which is more time lost from servicing your practice and the claim will have to be submitted once again and the will take more time away from your day …
