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 CPT found for Transposition of Ovary

Medical Billing CPT found for Transposition of Ovary There are many procedures in which there is no particular medical billing code to represent it. For instance, an Oophoropexy is usually performed for radiation therapy, but what if it were performed for polycentric ovarian syndrome? Is there a CPT code to represent this? Knowing your options is an important trait in the medical billing world. In the oophoropexy example above, some medical billing staff members may use the current procedural terminology code 58825 (Transposition, ovary). Unfortunately, they would be incorrect. The definition of transposition is when an ovary is moved due to radiation therapy. Since radiation therapy is not being performed,

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

Medical Billing for Emergency Procedures

Medical Billing for Emergency Procedures Knowing when to use code 90782 in emergency department procedures can help with your medical billing reimbursements. For example, if a doctor examines a patient in the ED for an injury, and injects a preventative tetanus toxoid, your first instinct might be to use 90782 as a modifier for this procedure. But you would not receive a medical billing reimbursement because the incident to provision does not apply in the emergency department so you would not be able to justify having the doctor administer this injection. There would be no way to justify the medical necessity of such a shot. However, when you are in

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

Medical Billing Denials During A Natural Disaster

Avoiding Medical Billing Denials During A Natural Disaster Several natural disasters in America have demanded a new medical billing policy. The insufficient relief effort after Hurricane Katrina made everyone want to proactively prepare, should another disaster occur. The healthcare industry has been no exception. A new medical billing condition code and modifier have been created for disaster related care for the present and future. The two new medical billing codes are DR (Disaster related), and CR (Catastrophe/Disaster Related). DR is a condition code and CR is a new medical billing modifier. All Medicare contractors must use the new codes on claims for August 21, 2005 and after. These medical billing

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

Avoiding Claim Denials For AMCC Tests

Avoiding Claim Denials For AMCC Tests When billing with medical modifier codes for automated multi-channel chemistry it is important to bill correctly to prevent denial. When a patient has end-stage renal disease it is important to use the 50/50 medical billing rule. This rule requires automatic multi-channel chemistry tests to be correctly identified on claims. Recently, the Centers for Medicare & Medicaid services has decided to deny laboratory claims that do not comply with this rule. The correct medical billing modifier for an automatic multi-channel chemistry test is required in order to prevent this denial from occurring. This is required when ever a medical end-stage renal disease facility or a

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

Outsourcing a Dirty Word toYou?

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

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