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.
October Updates Are In Effect!
If you haven’t already, make sure that your staff is using the updated CPT codes that were released in October 2008. Not doing so can lead to kick backs that will require more staff hours to research, redo and resubmit and if this happens on a number of claims it can seriously affect your reimbursements and in turn – slow your revenue flow to a mere trickle. One way to avoid this dilemma is to outsource your medical billing and yes, there are some horror stories out there about outsource companies that threw away patient billing, had lax attitudes towards billing submissions and wound up costing the physician a lot …
Correctly Reporting Wound Length
When a patient reports to the ED and requires laceration repair, the medical billing claim needs to address the length of the wound in order to be a properly filed claim. If the wound length is either not addressed or addressed incorrectly, the claim may be either denied, rejected or only partially paid. Additional factors can include whether or not there was a separate evaluation and how the service was managed during the encounter. Make sure all of these factors are documented in your medical billing claim. Laceration repairs are very common in the ED, in fact a nationwide survey showed that every one in fifteen patients presenting in the …
Getting Those "Q" Modifiers Right For Medicare
Remember when medical billing used to be a simple affair of matching the procedure done with a couple of medical billing codes to describe what was done, attaching your documentation and then submitting your medical billing claim for reimbursement? Now we have codes for codes and modifiers and the need to when to bundle and when to not bundle with the goal being fair reimbursement for procedures done. Modifiers cause a lot of confusion for many medical billers. One such confusing modifier that is worth clarifying is Q6. This applies to Medicare medical billing claims only, but in a nutshell when one of your staff physicians takes a leave of …
Emphysema Diagnosis Coding Tips
Want to know why your emphysema claims aren’t being fully reimbursed? Often, the reason is that you’re lacking two things when you submit your claim. You aren’t being detailed enough with your coding and your don’t have enough detailed medical documenation to back up your full diagnostic testing that is required to accurately diagnose emphysema and narrow the degree and type. When you’re compiling the medical billing for an established patient with active emphysema (492.8, Other emphysema) and they present and are complaining of shortness of breath (786.05); the physician provides inhalation treatment, trains the patient on using the nebulizer at home, and provides an expanded problem-focused examination and medical …
Definity Still Definitely a Problem in 2007
The injectable contract agent named Perflutren better known as Definity has caused a lot of confusion as many providers are billing the incorrect code and Medicare and most other large payors switched the code for this service in late 2005 and 2 years later it’s still showing up on medical billing and causing numerous delays and rejections on medical billing reimbursements. If you’re a service provider that is still billing A9700, you could face delays in getting paid–or even denials on your medical billing claims. If the carrier approves the main echocardiography procedure, then it will usually approve the use of Definity as contrast. If you are not sure of …
